盐酸环喷托酯滴眼液和复方托品卡胺睫状肌麻痹效果比较

目的:了解盐酸环喷托酯滴眼液和复方托品卡胺滴眼液在散瞳验光中麻痹睫状肌的临床效果,客观地对其评价以指导临床工作。 方法:随机抽取2010-12/2011-03期间的60例120眼屈光不正（近视和远视各占50%）患者,年龄12～40岁,利用国产复方托品卡胺滴眼液滴眼散瞳先后对其进行散瞳4次, 45min以后,对其进行检影验光,并利用综合验光仪测定其残余调节量,第2d用盐酸环喷托酯眼液进行复验。 结果:远视组盐酸环喷托酯滴眼液和复方托品卡胺两者验光结果差异较大（P＜0.01）;近视组两者验光差异较小（P＜0.05）,但是仍然具有统计学差异。 结论:临床上对于屈光不正患者的屈光检查,复方托品卡胺滴眼液是一种有效的睫状肌麻痹剂,但因注意到其麻痹睫状肌及放松调节的有限性,特别在远视患者应灵活结合其他放松调节如盐酸环喷托酯眼液的方法获取最终的配镜处方。     

应用托吡卡胺与阿托品眼液对青少年远视散瞳验光的对比研究

目的对比托吡卡胺与阿托品眼液对青少年远视散瞳验光的结果。方法用托吡卡胺与阿托品眼液对143眼青少年远视进行散瞳视网膜检影验光。结果143眼远视球镜度数两次验光结果相同和相差≤0.50D者93眼、相差0.75D以上者50眼、远视球镜度数符合率为65.0%,78眼复性远视柱镜度数2次验光结果相同和相差≤0.50D者为71眼、相差0.75D以上者7眼、复性远视柱镜度数符合率为91.0%,散光轴向符合率为82.1%。本组资料2种不同散瞳剂散瞳验光结果对比远视球镜或复性远视柱镜度数相差0.75D以上者均为托吡卡胺低于阿托品散瞳验光的度数。结论青少年远视患者睫状肌调节力大,对青少年远视患者应用托吡卡胺散瞳验光仍可存留部分调节的隐性远视的屈光度数。阿托品眼液用于青少年远视散瞳验光麻痹睫状肌彻底,可暴露全部的远视度数。对青少年远视仍以阿托品眼液散瞳验光为宜。     

快速散曈验光在儿童屈光测量中的临床应用

目的探讨复方托吡卡胺眼水快速散曈验光在儿童屈光测量中的应用范围。方法用复方托吡卡胺眼水和1%阿托品眼用凝胶先后分别对202例(382只眼)眼位正常屈光不正儿童散瞳后进行视网膜检影验光,采用自身配对t检验对两种药物散瞳检影结果进行比较。结果 4～7岁组远视、近视和8～11岁组远视两种药物散瞳检影验光所得结果差异有显著统计学意义(P<0.05);8～11岁组近视、12～15岁组远视、近视两种药物散瞳检影验光所得结果差异无统计学意义(P>0.05)。结论复方托吡卡胺快速散瞳验光方法适用于眼位正常的8岁及以上近视儿童和12岁及以上远视儿童。     

阿托品凝胶、盐酸环喷托酯和复方托吡卡胺睫状肌麻痹效果比较

目的：比较阿托品凝胶、盐酸环喷托酯和复方托吡卡胺在近视中小学生睫状肌麻痹验光中的效果,为科学验光和准确矫正提供理论依据。

方法：选取2017-07/08在我院经小瞳验光诊断为近视的中小学生420例818眼,按年龄分为3组,分别采用阿托品凝胶、盐酸环喷托酯和复方托吡卡胺进行睫状肌麻痹验光(散瞳验光)及小瞳复光。

结果：阿托品组、盐酸环喷托酯组、复方托吡卡胺组睫状肌麻痹验光与小瞳复光等效球镜符合率分别是：81.0%、81.3%和79.4%; 睫状肌麻痹验光与小瞳复光等效球镜之差阿托品组为-0.113±0.226D,差异有统计学意义(t=-4.663,P<0.001); 盐酸环喷托酯组为-0.025±0.192D,复方托吡卡胺组为-0.026±0.193D,差异均无统计学意义(t=-1.665,P=0.099; t=1.760,P=0.080)。

结论：对>8岁的近视中小学生,首次睫状肌麻痹验光可采用快速散瞳,以减少对学习生活的影响; 快速散瞳者复光配镜时可按小瞳结果直接给予处方,阿托品散瞳者小瞳复光近视屈光度高于散瞳时,配镜时需参考散瞳结果,选择最佳矫正视力的最低负镜度,避免近视过矫。     

国产盐酸环喷托酯滴眼液和托吡胺对眼睫状肌麻痹效果的比较研究

目的:观察国产盐酸环喷托酯滴眼液对人眼睫状肌麻痹和瞳孔散大的效果。方法:入选者48例左右眼随机分入试验组和对照组,分别滴用10g/L盐酸环喷托酯滴眼液和托吡卡胺滴眼液,每次1滴,隔5min再滴1次。于给药前1/6,给药后1/3,3/4,5/4,24,48h检查瞳孔直径和残余调节量。结果:国产盐酸环喷托酯的散瞳效应较托吡卡胺弱(P<0.01),但持续时间较长(P<0.01);盐酸环喷托酯的麻痹睫状肌效应较托吡卡胺强(P<0.01),持续时间也较长(P<0.01)。结论:盐酸环喷托酯滴眼液是一种安全有效的睫状肌麻痹剂,其麻痹睫状肌的效果优于托吡卡胺。     

盐酸环喷托酯对儿童睫状肌麻痹效果的观察

目的:探讨盐酸环喷托酯滴眼液对屈光不正儿童验光睫状肌麻痹的效果。方法:对6～12岁屈光不正儿童60例120眼随机分为3组,分别用盐酸环喷托酯滴眼液、复方托吡卡胺滴眼液及阿托品眼膏滴眼。在用药前及用药后不同时间点对3组患者分别在电脑验光仪上进行客观验光并测量瞳孔直径,在综合验光仪上进行主观验光并用移近法测量调节力和剩余调节力。结果:盐酸环喷托酯滴眼液最大睫状肌麻痹时间是60min,在最大睫状肌麻痹状态下盐酸环喷托酯组剩余调节力较复方托吡卡胺组小(P<0.05),与阿托品组相近(P>0.05)。结论:用盐酸环喷托酯代替阿托品对6～12岁屈光不正非斜视儿童进行散瞳验光是可行的。     

新时期成年人近视患者散瞳验光的必要性探讨

目的:探讨成年人近视眼患者复方托吡卡胺散瞳前后的电脑验光结果的差异性。方法:应用TOPCON8000型电脑验光仪记录72例144眼18~30岁长时间近距离用眼的成年人近视患者复方托吡卡胺散瞳前后的电脑验光数据,并对记录结果进行统计学分析。结果:长时间近距离用眼的成年人近视患者复方托吡卡胺散瞳前后电脑验光结果具有显著差异性(P<0.01)。结论:对于新时期有长时间近距离用眼工作史的成年近视患者,复方托吡卡胺散瞳验光仍有必要性。     

睫状肌麻痹前后眼屈光状态的变化

用0.5%托吡卡胺眼水,对181名(362眼)4—30岁屈光不正者进行了睫状肌麻痹前后的检影验光对照研究。与常态下相比,用睫状肌麻痹剂后,近视度减少,远视度增加。远视组和近视组的球镜度符合率分别为25.5%和62.4%。散光轴位变化率为48.8%。结果表明,散瞳检影后的主观试镜是必不可少的。     

青少年复方托品酰胺与阿托品散瞳检影的比较

在我国,青少年屈光不正常采用阿托品和复方托品酰胺滴眼液散瞳验光,为避免阿托品滴眼液散瞳持续时间长带来的学习生活不便,有人提出用复方托品酰胺代替阿托品作为睫状肌麻痹剂应用于散瞳验光。我院自2002年以来对门诊3~14岁青少年,先后用复方托品酰胺和阿托品散瞳后检影验光对照研究,现报告如下。1资料与方法1.1一般资料年龄3~14岁诊断为屈光不正的患儿共350例700眼,其中3~7岁150例,7~14岁200例。1.2方法先用复方托品酰胺眼液滴眼,每间隔5min滴眼1次,共4次,最后1次滴眼30min后检影并记录结果。第2d用阿托品眼液滴眼,每日3次,3d后检影并记录…     

盐酸环喷托酯滴眼液在远视儿童散瞳验光中的应用

目的：研究盐酸环喷托酯滴眼液在远视儿童散瞳验光中的综合应用效果。方法：选取2014－02／2015－03于本院进行散瞳验光的84例远视儿童为研究对象,将其分别采用托吡卡胺和盐酸环喷托酯滴眼液进行散瞳验光,然后将两种方法的屈光度结果、给药前及给药后不同时间的瞳孔直径及残余调节量进行比较,并比较两种方法中不同严重程度者的检查结果。结果：两种检查方法的屈光度检查结果、给药前的瞳孔直径及残余调节量无统计学差异（P＞0．05）,而给药后20、40、60 min及24 h盐酸环喷托酯滴眼液的残余调节量均小于托吡卡胺（P＜0．05）,给药后60min两种方法的瞳孔直径无统计学差异（P＞0．05）,给药后48h两种方法的瞳孔直径均与给药前无统计学差异（P＞0．05）。结论：盐酸环喷托酯滴眼液在远视儿童散瞳验光中的综合应用效果较好,对于睫状肌麻痹的效果尤为明显。     

青少年近视综合验光与散瞳验光屈光度分析

目的:探讨初诊12～16岁青少年近视在应用综合验光仪验光与美多丽散瞳后验光,其结果的比较及临床意义。方法:在我院2009-01/09患者中随机抽取100例200眼初诊患者,年龄12～16(平均14.5)岁,其中男80眼,女120眼。近视在0.50～4.50DS,散光在0.50～2.00DC,对其进行基础检查,排除眼病。将综合验光仪验光得出的结果和美多丽P散瞳后插片验光得出的结果进行比较。结果:综合验光仪验光者屈光度的均值为-1.68±0.80D,美多丽P散瞳后插片验光者屈光度的均值为-1.54±0.80D,综合验光仪验光得出的结果比美多丽P散瞳后插片验光得出的结果高,差异有显著意义(P<0.05)。结论:对于初诊的12～16岁青少年近视患者,临床中还要广泛地应用美多丽P散瞳验光,比小瞳下综合验光仪验光结果更加可靠。     

托品酰胺滴眼液对眼睫状肌麻痹效果的客观观察

目的通过客观观察托品酰胺滴眼液的睫状肌麻痹效果．尝试对临床上如何更科学地使用托品酰胺滴眼液进行验光检查作出客观评价和指导。方法利用移近法、负镜法、“shin-Nippon Auto-Refractor”三种主客观方法测量21例（42眼）受试者在滴用托品酰胺后的调节幅度变化情况，分析托品酰胺的睫状肌麻痹效果和药效动力学。结果使用客观测量方法评价托品酰胺的药效动力学时．最佳睫状肌麻痹效果在第一次滴药后第45分钟出现残余调节M=（0．40±0．26）D，在同一时间用移近法所得的平均残余调节M=（1．80±0．60）D，负镜法所得的平均残余调节M=（1．62±0．42）D，三种方法测量残余调节的结果显示主观与客观测量方法之间差异有显著性（P〈0．05）。结论0．5％托品酰胺滴眼液是一种有效的睫状肌麻痹剂，适合正常人群（含轻度近视）眼科屈光检查时使用，同时应注意主观调节检查的缺陷，尽量使用客观检查结果作为科研依据。     

托吡卡胺眼液对学龄儿童假性近视的疗效观察

目的:探讨2.5g/L托吡卡胺眼液对儿童假性近视的防治效果。方法:对135例270眼接受2.5g/L托吡卡胺眼液治疗的近视儿童的临床资料进行回顾性总结分析。结果:2.5g/L托吡卡胺眼液治疗后,近视儿童的远视力不同程度提高,屈光状况呈近视度数降低,未发现明显药物不良反应。结论:2.5g/L托吡卡胺眼液对于防治学龄儿童假性近视是安全有效的。     

综合验光仪测量眼动参数确定青少年验光方法分析

目的 利用综合验光仪研究青少年近视患者的眼动参数与验光方法的关系.方法 随机选取2006年1月至2008年2月在眼科门诊就诊的7～14岁的近视患者208人.先给予HUVITZMRK-3100型电脑验光仪+HUVITZCRT-4000型综合验光仪检查,确定CAMP状态的验光结果后测量眼动参数,包括BCC,PRA,NRA.然后使用睫状肌麻痹剂3d后复查电脑验光再给予综合验光仪主觉验光检查,确定CAMP状态的验光结果,分别记录.结果 分别计算出散瞳前、后的CAMP状态的镜度值(散光度数以有效球镜度计算),然后比较不同的BCC,PRA,NRA值下,散瞳前、后球镜度是否有差异.对于符合BCC值<+0.25D、PRA值>-1.75D、NRA值<+1.75D、NRA值>+2.25D条件之一的青少年确实有必要行散瞳验光检查.结论 综合验光仪测量的眼动参数,对决定青少年近视患者的验光方法具有临床指导意义.     

RetCam3早产儿视网膜病变筛查中复方托吡卡胺眼液对散瞳效果及角膜厚度的影响

目的　通过复方托吡卡胺眼液对散瞳效果及角膜厚度影响的研究,为早产儿视网膜病变筛查提供更适宜的散瞳方法。方法　将进行ＲｅｔＣａｍ３早产儿视网膜病变初次筛查并需进行复查的早产儿１３１人,按不同用药方法分为Ａ、Ｂ、Ｃ、Ｄ四组,分别点入１、２、３、４次托吡卡胺眼液进行散瞳,在距最后一次散瞳１５ｍｉｎ、３０ｍｉｎ、４５ｍｉｎ时测量瞳孔直径和中央角膜厚度（ｃｅｎ-ｔｒａｌｃｏｒｎｅａｌｔｈｉｃｋｎｅｓｓ,ＣＣＴ）。结果　瞳孔散大程度组内比较:Ａ、Ｂ、Ｃ、Ｄ四组内各时间点两两比较差异均有统计学意义（均为Ｐ＜０．０５）;组间比较:散瞳１５ｍｉｎ时,Ａ组与Ｄ组、Ｂ组与Ｄ组、Ｃ组与Ｄ组差异均有统计学意义（均为Ｐ＜０．０５）;散瞳３０ｍｉｎ和４５ｍｉｎ时,Ａ组与Ｂ组、Ａ组与Ｃ组、Ａ组与Ｄ组、Ｂ组与Ｄ组、Ｃ组与Ｄ组差异均有统计学意义（均为Ｐ＜０．０５）。ＣＣＴ组内比较:Ａ、Ｂ、Ｃ、Ｄ四组内各时间点间两两比较,差异均有统计学意义（均为Ｐ＜０．０５）;组间比较:散瞳３０ｍｉｎ和４５ｍｉｎ时,Ａ组与Ｃ组、Ａ组与Ｄ组、Ｂ组与Ｃ组、Ｂ组与Ｄ组ＣＣＴ差异均有统计学意义（均为Ｐ＜０．０５）。结论　使用２次散瞳药,在距最后一次散瞳３０ｍｉｎ时进行ＲｅｔＣａｍ３早产儿视网膜病变筛查为最佳散瞳方案。     

Intraocular pressure in anisometropic children.

BACKGROUND: There is evidence that intraocular pressure (IOP) is higher in myopes than in hyperopes or emmetropes, and it has been suggested that myopia may be the result of a high IOP. We studied IOP in the two eyes of anisometropes, thus controlling for nuisance variables affecting IOP measurement. METHODS: Sixty-seven Chinese children, aged between 8 and 14 years, with anisometropia not <2 D were studied. A Topcon CT-60 noncontact tonometer was used for IOP measurement. Cycloplegia was achieved using two drops of tropicamide 1%, and retinoscopy was performed after residual accommodation had decreased to <2 D. A-scan ultrasonography was carried out using a Storz Alpha II Biometric Ruler. RESULTS: There were no statistically significant differences in IOP between the less myopic and more myopic eyes. CONCLUSIONS: Refractive error and axial length differences in anisometropic children are not related to differences in IOP and seem more likely to be due to genetically determined discrepancies in scleral structure, as previously proposed.     

Insulin and tropicamide accumulate in the contralateral, untreated eye of rats following ipsilateral topical administration by a mechanism that does not involve systemic uptake.

BACKGROUND: This study was designed to determine: (1) whether the accumulation of insulin in the contralateral retina and aqueous humor following ipsilateral topical insulin administration was due to systemic uptake and (2) whether tropicamide, applied to one eye, could induce dilation in the contralateral eye by a mechanism that did not involve systemic uptake. METHODS: Insulin eye drops were applied to the left eye of intact and decapitated rats, and their retinas and aqueous humors were then removed and their insulin levels quantified. In a separate experiment live animals received 0.1% tropicamide in their left eye and had their pupillary dilation response in both eyes measured at different time points. RESULTS: Administration of insulin to the left eye of decapitated rats resulted in its significant accumulation not only in the left retina and aqueous humor, but also in the retina and aqueous humor of the right eye. Similar aqueous humor results were obtained when live animals were used. Tropicamide drops induced marked pupillary dilation in treated eyes; the pupils of the contralateral, untreated eyes also dilated significantly, but less than did the treated pupils. The pupils of rats injected with tropicamide intravenously showed negligible dilation. CONCLUSIONS: These results showed that insulin accumulated in the retina and aqueous humor of contralateral, untreated eyes following topical application, by a mechanism that did not appear to involve systemic uptake. Similarly, tropicamide provoked a dilation response in the unheated eye by a mechanism that similarly did not appear to involve uptake from the blood.     

视欣二结合治疗青少年近视疗效观察

目的　探讨视欣二结合治疗青少年近视的疗效。方法　经眼科检查后,选取假性近视和轻度近视青少年患者98例196眼。根据使用调节麻痹药物后屈光度的变化将患眼分为假性近视组A(18例),混合性近视组B(35例)和低于3.00D的轻度近视组C(25 例)及配镜组D(20 例)。将假性近视组A随机化分为视欣二结合组A1 和双星明眼液组A2;B、C组为视欣二结合治疗组;D1组为配镜联合视欣二结合间断治疗组。结果　对假性近视,视欣二结合治疗组疗效优于双星明眼液组(t=2.52, P<0 05);视欣二结合治疗青少年混合性近视能提高患者视力,改善屈光度(tv=8.66, P<0 01; td=2.56, P<0.05);视欣二结合治疗真性近视能改善视力(t=3.80,P<0.01),但屈光度无改善;视欣二结合有助于戴镜患者视力稳定,而屈光度变化无显著差异(tv=5.31, P<0.01; td=0.66, P>0 05)。结论　视欣二结合可提高近视患者视力,纠正调节痉挛所致的假性近视,不能纠正真性近视性屈光不正。     

Eight-year follow-up of photorefractive keratectomy for myopia

PURPOSE: We evaluated 8-year results of excimer laser photorefractive keratectomy (PRK) for myopia in terms of stability and late complications. METHODS: Ninety-two myopic eyes of 55 patients were treated with a single-step method using an Aesculap-Meditec MEL 60 excimer laser with a 5.0-mm ablation zone. Treated eyes were divided into three groups according to preoperative refraction: low myopes (< or = -6.00 D), medium myopes (-6.10 to -10.00 D), and high myopes (>-10.00 D). RESULTS: Change in myopic regression stabilized in all myopia groups within 12 months, although a small myopic shift occurred up to 8 years after PRK. Mean change in refraction between 2 and 8 years was -0.42 +/- 0.48 D for low myopes, -0.37 +/- 0.34 D for medium myopes, and -0.41 +/- 0.50 D for high myopes. The percentage of eyes within +/- 1.00 D of emmetropia 8 years after PRK was 78.3% in the low myopia group, 68.8% in the medium myopia group, and 57.1% in the high myopia group. One eye lost 2 lines of best spectacle-corrected visual acuity due to irregular astigmatism. In 13.0% of eyes, a residual trace corneal haze was observed, which had no effect on visual acuity. Apart from the loss of 2 lines of BSCVA in one eye, there were no other late complications during the study period. CONCLUSIONS: The mean change in refraction between 2 and 8 years was less than -0.50 D, regardless of preoperative refraction, and may be attributed to natural age-related refractive change. The appearance of residual corneal haze after 8 years correlated with the amount of myopic correction. PRK was a safe and stable surgical procedure in this group of patients.