The Relation of Myopia and Astigmatism in Developing Eyes

The relation of astigmatism and myopia was analyzed in 298 myopic children, ages birth to 10 years. The mean spherical equivalent, determined by cyclopentolate retinoscopy, for the entire group was ?2.9 diopters and did not change significantly with age. However, in 3-year-old children and younger, myopia progressed in eyes with ?1 diopter of cylinder and tended to increase through age 8 years in those having ?3 diopters of cylinder. Also, astigmatic errors ?1 diopter, especially of oblique orientation, were associated with higher degrees of myopia than nonastigmatic errors. These data from myopic children suggest that uncorrected astigmatism during a period of visual immaturity influences the course of myopia. Thus, naturally occurring astigmatic errors, that are frequent among infants and young children, appear to have a role similar to the vision blurring perturbations that trigger the development of myopia in young animals. Ascertainment and full correction of these refractive errors in young children may be important in assuring the best possible vision.     

高度近视并发性白内障患者术前角膜 后表面散光特征

目的：分析高度近视并发性白内障患者术前角膜后表面散光（PA）的特征。方法：系列病例研究。收 集2018年1-6月期间就诊于山西省眼科医院的白内障患者215例（215眼）,按照眼轴长度（AL）分为 高度近视组（AL≥26 mm）和对照组（20 mm≤AL＜26 mm）。其中高度近视组94例（94眼）,对照组 121例（121眼）,术前行Pentacam检查,分析PA、总角膜散光（TA）、模拟角膜散光（KA）的分布特点 及相关性,采用算术法和矢量法分析TA与KA的差异。2组间计量资料比较采用独立样本t检验,角 膜后表面散光的相关性分析采用Pearson相关分析。结果：高度近视组PA为（-0.33±0.20）D,其中 79.6%为逆规散光,大于0.5 D的患眼占30.8%,对照组PA为（-0.31±0.18）D,2组之间差异无统计学 意义（t=0.589,P=0.557）。高度近视组KA与TA的矢量误差为（0.12±0.21）D@4°,其中24.5%患眼二 者之间误差≥0.5 D。PA与KA、Km（KA）、Km（PA）之间呈正相关性（r=0.340,P=0.001;r=0.285, P=0.006;r=0.333,P=0.001）,对于KA＞0.5 D患者,KA和PA轴位差值与TA和KA差值之间呈正相 关性（r=0.235,P=0.004）。结论：高度近视组角膜后表面散光分布与对照组之间差异无统计学意义。 高度近视组忽略PA同样会导致TA计算误差,对植入Toric人工晶状体的患者应考虑输入个性化PA值。     

近视相关的多因素分析

目的了解与近视相关的多种因素对近视的综合影响程度。方法用多元逐步回归分析法对３９７眼ＰＲＫ术前的屈光状态，角膜地形图测得的角膜屈折力以及角膜多点厚度、眼轴长、晶体厚和前房深等测量值进行分析。结果眼轴、合并散光和年龄与近视度呈显著正相关，角膜垂直平均厚度呈显著负相关。近视＞８．０Ｄ者角膜中心厚度和垂直厚度显著薄于＜８．０者。有３个因素与之呈线性正相关：眼轴（Ｂ＝０．４７３），散光度（Ｂ＝０．３７６）和年龄（Ｂ＝０．０７０）。结论上述三因素应为近视手术的主要控制和观察指标。     

角膜地形图检查在预测复性近视散光中的作用

目的探讨角膜散光与睫状麻痹后视网膜检影散光度数的相互关系。方法角膜地形图检查散光大于０．５Ｄ的７２眼同时睫状麻痹后视网膜检影确定散光度数和散光轴，统计学分析两者的相互关系。结果二种检查的散光度数相关系数ｒ＝０．５０９，散光轴相关系数ｒ＝０．９２９。结论角膜屈光力改变一定程度上可引起散光，但全眼散光仍应以睫状麻痹后检影、插片接受的度数和散光轴作为标准。     

RGPCL与框架眼镜对高度近视和散光的矫正效果

目的：探讨硬性透气性角膜接触镜（RGPCL）与框架眼镜对高度近视和散光的矫正效果。方法：回顾性自身对照研究。选择2017年1月至2018年12月在惠州爱尔眼科医院视光与小儿眼科门诊验配RGPCL且连续配戴1个月以上并在配戴RGPCL前连续配戴框架眼镜1个月以上的患者41例（75眼）,其中高度近视眼38眼（高度近视组）,高度散光眼37眼（高度散光组）。分别比较2组组内配戴框架眼镜和RGPCL的矫正效果。数据采用配对t检验进行比较。结果：41例（75眼）均成功验配RGPCL。高度近视组配戴RGPCL的最佳矫正视力（BCVA）为5.02±0.16,而配戴框架眼镜BCVA为4.91±0.16,差异有统计学意义（t=11.204,P=0.001）,其中13眼BCVA在配戴RGPCL后提高2行至2行以上,1眼视力下降。高度散光组配戴RGPCL的BCVA为4.95±0.10,而配戴框架眼镜的BCVA为4.83±0.16,差异有统计学意义（t=8.431,P=0.001）,其中12眼BCVA在RGPCL的配戴下提高2行至2行以上。结论：配戴RGPCL在矫正高度近视与散光的视力效果方面优于框架眼镜,具有临床优势。     

散光对低中度近视青年患者客观视觉质量的影响

目的：运用双通道技术客观评估散光对低中度近视青年患者视觉质量的影响。

方法：回顾性分析2017-06/09来我院视光中心就诊的低中度近视青年患者258例479眼,按散光度数不同分为4组：-1D<散光度≤0D为L组、-2D<散光度≤-1D为M组,-3D<散光度≤-2D为H组、-4D≤散光度≤-3D为S组。采用基于双通道技术的视觉质量分析系统(OQASTM Ⅱ)检查患者视觉质量,记录并分析MTF cutoff、OSI、SR、OV100%、OV20%、OV9%等参数。

结果：随着散光度数的增加,MTF cutoff、SR、OV100%、OV20%、OV9%值逐渐降低,OSI值逐渐增大。除MTF cutoff和OSI在L组和M组受检者之间差异无统计学意义(P>0.05),其余参数各组之间差异均有统计学意义(P<0.05)。本组受检者MTF cutoff 、SR与年龄均无明显相关性,与散光度呈负相关; OSI与年龄无明显相关性,与散光度呈正相关。

结论：散光对低中度近视青年患者客观视觉质量有影响,随着散光度的增加视觉质量逐渐下降。     

IMI Accommodation and Binocular Vision in Myopia Development and Progression

The role of accommodation in myopia development and progression has been debated for decades. More recently, the understanding of the mechanisms involved in accommodation and the consequent alterations in ocular parameters has expanded. This International Myopia Institute white paper reviews the variations in ocular parameters that occur with accommodation and the mechanisms involved in accommodation and myopia development and progression. Convergence is synergistically linked with accommodation and the impact of this on myopia has also been critiqued. Specific topics reviewed included accommodation and myopia, role of spatial frequency, and contrast of the task of objects in the near environment, color cues to accommodation, lag of accommodation, accommodative-convergence ratio, and near phoria status. Aspects of retinal blur from the lag of accommodation, the impact of spatial frequency at near and a short working distance may all be implicated in myopia development and progression. The response of the ciliary body and its links with changes in the choroid remain to be explored. Further research is critical to understanding the factors underlying accommodative and binocular mechanisms for myopia development and its progression and to guide recommendations for targeted interventions to slow myopia progression.     

0.02%和0.01%阿托品滴眼液对近视儿童散光的影响

目的：观察0.02%和0.01%阿托品滴眼液对近视儿童的总散光和角膜散光的影响。方法：前瞻性队列研究。收集2016年6月至2017年6月就诊于郑州大学第一附属医院的400例近视儿童,其中0.02%阿托品+框架眼镜组138例,0.01%阿托品+框架眼镜组142例,单纯框架眼镜组120例。2个阿托品组均配戴全矫单焦框架眼镜,且每晚睡前双眼同时滴用0.02%或0.01%的阿托品滴眼液;单纯框架眼镜组仅配戴全矫单焦框架眼镜。每4 个月复查1 次,共随访1 年。采用IOLMaster测量角膜曲率;睫状肌麻痹验光获得等效球镜度数;标准矢量分析方法检测总散光和角膜散光（包括X、Y和轴向）。均选取右眼数据进行分析。采用方差分析、秩和检验和卡方检验进行数据分析。采用重复测量方差分析和广义估计方程GEE模型比较患者总散光、角膜散光以及角膜散光轴向的变化规律。结果：1年后,单纯框架眼镜组、0.01%阿托品+框架眼镜组、0.02%阿托品+框架眼镜组的总散光（包括X）均有所增加,差异有统计学意义（总散光：F时间=15.25,P=0.001;总散光X：wald χ2时间=48.07,P<0.001）,但3 组间增加幅度基本一致,差异无统计学意义。3组的角膜散光（包括X）均逐渐增加,差异均有统计学意义（角膜散光：F时间=8.11,P=0.001;角膜散光X：wald χ2时间=20.79,P<0.001）,但3组间增加幅度基本一致,差异无统计学意义。随着治疗时间的延长,3 组的总散光Y、角膜散光Y、总散光轴向和角膜散光轴向均稳定,且组间差异均无统计学意义。结论：近视儿童每晚规律应用0.02%或0.01%的阿托品滴眼液1年,对标准矢量分析法的总散光、角膜散光及二者的轴向均无影响。     

Canonical Wnt Signaling Drives Myopia Development and Can Be Pharmacologically Modulated

PurposeThe purpose of this study was to evaluate the role of the canonical Wnt signaling in the development of the myopia.MethodsPlasma from adult patients with myopia, myopic animal models including the adenomatous polyposis coli (APC) gene mutation mouse model, and the form deprivation (FD) induced mouse model of myopia were used. Niclosamide, a canonical Wnt pathway inhibitor, was orally administrated in animal models. Plasma levels of DKK-1 were determined by using enzyme-linked immunosorbent assay. Refraction, vitreous chamber depth (VCD), axial length (AL), and other parameters, were measured at the end of the FD treatment. Canonical Wnt signaling changes were evaluated by Western blot analysis and immunostaining analysis.ResultsPlasma level of Wnt inhibitor DKK-1 was markedly decreased in patients with myopia. Meanwhile, the canonical Wnt pathway was progressively activated during myopia development in mice. Moreover, inhibition of canonical Wnt signaling by niclosamide in mouse models markedly reduced lens thickness (LT), VCD, and AL elongation, resulting in myopia inhibition.ConclusionsDysregulation of canonical Wnt signaling is a characteristic of myopia and targeting Wnt signaling pathways has potential as a therapeutic strategy for myopia.     

Meridional Anisotropy of Foveal and Peripheral Resolution Acuity in Adults With Emmetropia,Myopia, and Astigmatism

PurposeTo quantify astigmatism-related meridional anisotropy in visual resolution at central, nasal, and inferior visual fields.MethodsThree groups of young adults (range, 18–30 years) with corrected-to-normal visual acuity (logMAR 0) were recruited: (1) myopic astigmats (MA): spherical-equivalent error (SE) < −0.75D, with-the-rule astigmatism ≥ 2.00D, n = 19; (2) simple myopes (SM): SE < −0.75D, astigmatism ≤ 0.50D, n = 20; and (3) emmetropes (EM): SE ± 0.50D, astigmatism ≤ 0.50D, n = 14. Resolution acuity was measured for the horizontal and vertical gratings at central and peripheral visual fields (eccentricity: 15°) using a 3-down 1-up staircase paradigm. On- and off-axis refractive errors were corrected by ophthalmic lenses.ResultsThe MA group exhibited meridional anisotropy preferring vertical gratings. At the central field, the MA group had better resolution acuity for vertical than horizontal gratings, and their resolution acuity for horizontal gratings was significantly worse than the SM and EM groups. At peripheral visual fields, both the SM and EM groups showed better resolution acuity for the radial (i.e., nasal field: horizontal gratings; inferior field: vertical gratings) than tangential orientation. However, the MA group tended to have better resolution acuity for the tangential orientation (i.e., vertical gratings), and their resolution acuity for horizontal gratings was significantly lower than the SM and EM groups at the nasal field. No significant differences were found in the inferior field among the three groups.ConclusionsThis study provided evidence of astigmatism-related meridional anisotropy at the fovea and nasal visual fields, underscoring the significant impact of astigmatism on orientation-dependent visual functions.     

儿童总散光与角膜散光及眼内散光的多重线性回归分析

目的：探讨儿童眼总散光与角膜散光、眼内散光的线性关系。方法：系列病例研究。选取2018年 6─12月在连云港市妇幼保健院行睫状肌麻痹验光且散光度≥1.00 D的3～6岁儿童,按入选标准选 取76例（126眼）,收集睫状肌麻痹后角膜散光度及轴位、眼总散光度及轴位4组数据。运用矢量的 平行四边形法则及三角函数公式分析并计算眼内散光度及轴向,对总散光度与角膜散光度、眼内 散光度做多重线性回归分析。结果：眼总散光度与角膜散光度、眼内散光度遵循Ctotal=0.004+0.988 ×Ccorneal+0.928×Cintraocular（R2 =0.998,P<0.001）。眼总散光轴向与角膜散光轴向、眼内散光轴向遵循 Atotal=48.391+0.708×Acorneal-0.185×Aintraocular（R2 =0.531,P<0.001）。126只散光眼的眼内散光中远视性 散光92眼（73.0%）,散光度最小值+0.25 D,最大值+2.00 D,平均（+0.58±0.29）D;近视性散光34眼 （27.0%）,散光度最小值-0.03 D,最大值-1.03 D,平均（-0.26±0.24）D。结论：眼总散光度与角膜 散光度、眼内散光度呈高度线性相关。可通过公式Ctotal=0.004+0.988×Ccorneal+0.928×Cintraocular反推计 算出眼内散光度,且准确性高。大部分眼内散光对角膜散光起补偿抵消作用,对角膜散光轴向影响小, 眼内散光以逆规散光为主。     

Myopia and visual acuity impairment: a comparative study of Greek and Bulgarian school children

Purpose:  To compare the proportions of school children with myopia and impaired visual acuity in Greece and Bulgaria.
Methods:  A sample of 898 children, aged 10–15 years, was selected from two primary and two secondary schools in a Greek city (Heraklion), and one primary and secondary school in a Bulgarian city (Stara Zagora). Five hundred and eighty eight children were Greek (65.5%, mean age 12.5 ± 0.08 years) and 310 Bulgarian (34.5%, age 12.4 ± 0.07 years). VA was assessed with the habitual refractive correction. Refractive error was measured in the absence of cycloplegia using an auto-refractor.
Results:  The percentage of children, tested with their habitual refractive correction, with decimal VA <0.5 in at least one eye was 11.7% (95% CI 9.1–14.3%) for Greek and 5.2% (95% CI 2.7–7.6%) for Bulgarian pupils. The percentage of myopic children also differed between the two countries with the proportion with myopic refractive error ≤−0.75 D and decimal VA <0.8 at primary school level being 14.1% and 28.9% in Stara Zagora and Heraklion respectively and 13.0% and 46.9% (95% CI 18.2–29.2%, p  < 0.0001) at secondary school level. Among the myopic pupils only 35.8% used corrective spectacles in Stara Zagora, compared to 70.7% of the children in Heraklion. Finally, myopia appeared more prevalent in female adolescents with the effect being statistically significant only for Greek children (55% vs 40% of males, p  = 0.015).
Conclusions:  The increased proportion of myopic children in Heraklion, compared to Stara Zagora, may arise from a number of environmental and socio-economic factors, which need to be further investigated in order to understand the differences observed among European populations.     

散光患者的角膜散光轴位与总合散光轴位的分析

目的通过统计分析屈光不正患者总合散光的轴位与角膜散光的轴位的关系和大小,为验光配镜、隐形眼镜的基弧及散光性隐形跟镜的轴位选择、准分子激光的手术量计算提供参考.方法对107例屈光不正患者,用同一电脑验光仪对其同时、同眼、同状态的情况下作屈光状态的测定及角膜曲率的测定,每人重复3次,通过电脑记录,得出总合散光及角膜散光的轴位,进行统计分析.结果近视患者的总合散光轴位与角膜散光的轴位的夹角是5.73°±3.97°,混合散光患者的总合散光轴位与角膜散光的轴位夹角为3.13°±2.49°,远视患者的总合散光轴位与角膜散光的轴位夹角为6.35°±4.20°.结论眼屈光状态中总合散光的轴位与角膜散光的轴位所构成的夹角主要是由于晶体及角膜内表面散光的轴位不一致所引起.眼科学报2000;16279～280.     

经上皮准分子激光角膜切削术治疗近视散光术后散光的矢量分析

目的：采用Alpins矢量分析法分析经上皮准分子激光角膜切削术 （TransPRK）治疗近视散光的效果,探讨影响散光矫正的因素。方法：回顾性系列病例研究。收集2014年1月至2016年6月在汕头国际眼科中心行TransPRK矫正近视散光且术后坚持随访3个月的患者99例（167眼）,分成低散光组（-0.25～-0.75 D）和相对高散光组（-1.00～-4.75 D）。采用Alpins矢量分析法对手术前后散光的相关指标进行计算和评估,手术前后指标采用配对t检验;影响散光矫正的因素之间的相关性采用Pearson相关分析。结果：术前主觉验光球镜度为（-3.57±1.22）D,散光度为（-0.93±0.62）D。术后3个月主觉验光球镜度为（+0.12±0.25）D,散光度为（-0.04±0.23）D。目标矫正散光量绝对值（|TIA|）为（0.86±0.58）D,手术矫正散光量绝对值（|SIA|）为（0.87±0.59）D,误差量绝对值（|DV|）为（0.10±0.21）D,误差值（ME） （0.01±0.17）D,误差角（AE） （1.49±13.27）°,矫正指数（CI）为0.98±0.33。|SIA|与|TIA|呈正相关（r=0.94,P < 0.001）。|AE|与|DV|呈正相关（r=0.83,P < 0.001）。ME与|SIA|呈正相关（r=0.23,P < 0.001）。2组|DV|、ME和 CI相似;低度散光组的|AE|为5.78°±16.34°,相对高散光组为1.82°±4.41°,差异有统计学意义（t=2.02,P=0.04）。术后37只患眼（22.0%）有残余散光,其中60%的患者手术前后轴向改变量大于30°,发现术前散光轴变化呈逆时针改变,转轴度为-2.30°±45.88°。结论：TransPRK对散光的矫正效果与散光大小和轴向矫正的准确性关系密切,为了减少术后散光,需提高术中矫正散光大小和轴向的准确性。     

角膜地形图引导的准分子激光手术 与全飞秒激光微透镜取出术矫正 不对称角膜散光的疗效观察

目的：比较角膜地形图引导的2种准分子激光角膜屈光手术（Contoura Vision-LASEK和Contoura Vision-FS-LASIK）与飞秒激光小切口微透镜取出术（SMILE）矫正近视伴角膜不对称散光的疗效。 方法：前瞻性队列研究。对2017年6-8月在陆军军医大学第三附属医院行双眼CV-LASEK、CV-FS-LASIK和SMILE的角膜不对称散光患者（地形图显示角膜前表面6 mm直径范围内垂直彗差绝对 值｜C7｜>0.2 μm或水平彗差绝对值｜C8｜>0.2 μm）,采用随机数字生产法纳入患者双眼中的任一 眼,分别于术前,术后1周、1个月、3个月和6个月作裸眼远视力（UCVA,LogMAR）、屈光状态、 Pentacam HR眼前节分析、眼压、裂隙灯显微镜等检查,并于术后6个月行客观验光检查,采用多 变量方差分析法（MANOVA）分析3组患者在术后各时间点UCVA、眼压及角膜高阶像差（彗差采用 (|C7 | + |C8 |)/ 2 表示）等指标的变化及组间差异,并采用混合线性模型分析引起3组患者术后各时间点 角膜高阶像差差异的影响因素。结果：每组均纳入35例（35眼）,共105例。术后6个月时CV-LASEK 组UCVA较术前BCVA有1眼下降1行,1眼下降2行,其他2组无一眼发生UCVA下降,但3组间比较 差异无统计学意义（P=0.174）;3组间在术后各时间点的眼压和角膜前表面彗差、球差的差异均有统 计学意义（均P<0.05）,眼压波动是影响3组患者术后各时间点角膜高阶像差的因素（均P=0.001）,且 呈负相关性,而初始CCT是影响3组患者术后各时间点球差的因素（P=0.003）,且呈正相关性。结论： 对于近视伴角膜不对称散光患者的矫正,CV辅助的LASEK和FS-LASIK均可在准确矫正近视及近视 散光的同时,改善角膜的不规则性。但是,无论何种手术方式,都需密切关注患者术后眼压的波动。     

形觉剥夺近视早期雏鸡视网膜细胞凋亡相关研究

目的：观察雏鸡形觉剥夺性近视模型视网膜细胞凋亡相关的代谢变化。方法：实验研究。2021年8 月将48只8日龄白来航鸡随机分为对照组和形觉剥夺组。雏鸡8日龄时,形觉剥夺组分别予以右眼形觉剥夺1周和3周处理,作为形觉剥夺1周组和3周组,对照组不作形觉剥夺处理,与相应的形觉剥夺组培养相同的时间,作为对照1周组和对照3周组。所有组别均通过检影及A超测量雏鸡形觉剥夺前后屈光度、眼轴等数据,形觉剥夺结束后进行雏鸡视网膜电图、彩色立体眼底照相检查,视网膜切片苏木素-伊红（HE）染色以检测雏鸡眼底结构及功能变化,并使用Western blot方法检测雏鸡视网膜中凋亡相关因子bax、bcl-2、caspase-3、caspase-8的表达水平变化,使用透射电子显微镜观察视网膜细胞超微结构的变化。采用独立样本t检验进行数据分析。结果：①形觉剥夺1周（t=3.53, P=0.002）或3周（t=18.21,P<0.001）组雏鸡眼轴增长量均明显大于相应的对照1周组和对照3周组,且形觉剥夺3周组雏鸡眼轴增长量明显大于形觉剥夺1周组（t=5.28,P=0.030）;与各自对照组相比,形觉剥夺1周（t=12.40,P<0.001）或3周（t=12.37,P<0.001）的雏鸡屈光度均向负值方向增大,且形觉剥夺3周雏鸡屈光度明显负于1周雏鸡屈光度（t=2.63,P=0.030）。②在形觉剥夺1周和3周雏鸡中,视网膜电图与对照组相比均未见明显差异（均P>0.05）,眼底照相和切片HE染色均未见异常。③形觉剥夺1周和3周后,视网膜bcl-2（t=2.77,P=0.040;t=4.58,P=0.044）表达水平均较相应的对照组下降,bax（t=2.99,P=0.040;t=4.77,P=0.018）、caspase-3（t=3.44,P=0.026;t=3.25,P=0.023）、caspase-8（t=5.82,P=0.028;t=5.38,P=0.013）表达水平均较对照组上升。④对照组和形觉剥夺1周组雏鸡的视网膜细胞中未见明显细胞损伤表现,形觉剥夺3周组视网膜可见细胞质分布不均,染色质固缩,线粒体重度肿胀,嵴消失,空泡变,内质网脱颗粒等现象。结论：形觉剥夺早期雏鸡的眼底尚未出现病理性改变时,凋亡相关因子bax、bcl-2、caspase-3、caspase-8表达量已经发生改变,透射电镜提示视网膜组织发生了细胞凋亡。     

温州地区儿童青少年散光分布特征及其影响因素

目的：分析温州地区5～14 岁儿童青少年的散光分布特征,评估儿童青少年散光发生的主要影响因素。方法：横断面研究。收集2011 年9 月至2016 年3 月在温州医科大学附属第二医院儿童体检中心进行健康体检并同意参加本研究的儿童青少年525 名。对研究对象进行睫状肌麻痹下（1%盐酸环喷托酯滴眼液）下电脑验光, 测量身高、体质量、三围。并对陪同前来的父母进行非睫状肌麻痹电脑验光。收集儿童青少年年龄、性别、父母资料等信息,采用秩和检验、卡方检验及Logistic回归分析儿童青少年散光状态及其相关影响因素。结果：在525 名研究对象中有438 名（83.4%）完成研究,其中存在散光者（≥0.5 D）260名,检出率59.4%。散光在0.50～1.00 D者占80.8%、1.25～2.00 D占11.2%,＞2.00 D占8.1%。散光儿童青少年中肥胖比例更高（χ2=6.347,P =0.042）。散光类型以顺规散光为主（73.8%）,不同性别及各年龄组散光轴向分布差异均无统计学意义（χ2=3.104,P =0.212;χ2=10.578,P =0.102）。经矫正年龄、性别、体质指数后发现,与双方父母均无散光的儿童青少年相比,父母双方中一方有散光的儿童青少年的散光检出率更高（χ2=7.484,P =0.024）。母亲柱镜度增加,儿童青少年患散光的风险明显增加（OR =2.2,95%CI=1.1～4.4,P =0.023）。结论：温州地区参与常规体检儿童青少年的散光检出率为59.4%,以顺规散光为主,母亲有散光可能增加儿童青少年发生散光的风险。     

LASIK非球面与标准切削治疗近视及近视散光的早期观察

目的:分析比较LASIK非球面切削与标准切削治疗近视及近视散光后的视功能、角膜非球面形态(Q值)情况,并评价治疗效果.方法:分别对16名患者(32眼)使用非球面切削程序以及18名患者(36眼)使用标准切削进行LASIK手术,记录所有手术眼术前、后视力,屈光度、Q值以及术后眩光发生情况.结果:术后3mo所有手术眼视力矫正均满意,非球面切削组与标准切削组之间屈光度无差别(P＞0.01);但非球面切削组与标准切削组比较其术后角膜更倾向于长椭球形,Q值(0.19±0.26)明显低于标准切削组Q值(0.88±0.52)(P＜0.01),术后眩光发生率较标准切削组更低(P＜0.05).结论:使用非球面切削与标准切削行LASIK治疗近视及近视散光均是安全有效的,但采用非球面切削由于能够更好地维持角膜形态,与标准切削比较其术后视觉质量更好,效果更为理想.