托品酰胺与阿托品滴眼液对儿童验光结果的影响比较

目的了解对屈光不正儿童应用托品酰胺或阿托品滴眼液后，散瞳验光及复验结果的符合率。方法186例屈光不正患儿(共372只眼)，均先给予托品酰胺扩瞳，5 min滴眼1次，共3次，最后1次滴药后30 min进行检影验光，并于第2天复验。再嘱患儿自实验第2天复验后开始，用阿托品滴眼液每天滴眼3次，共3 d，第4天复诊时再行验光，并于3周后复验。比较两种药物散瞳验光和复验的结果。结果4～10岁屈光不正儿童远视占多数，～14岁则以近视多见。～14岁近视患儿采用托品酰胺与阿托品散瞳后验光及复验的结果差异无显著性(P＞0.05)，其他患儿采用这两种药物散瞳验光及复验的结果差异有显著性(P＜0.05)。结论托品酰胺是较大年龄(10～14岁)近视性儿童散瞳验光的理想药物，但对其他年龄段儿童和托品酰胺散瞳验光后发现有复性散光的患儿，应使用阿托品。

A Comparative Study of the Effect of Mydrin-P and Atropin Eye Drops on the Result of Optometry in Children

Objective To survey the accordance rates of mydriasis optometry and call-back examination after the application of mydrin-P and atropin eye drops in children with ametropia. Methods 186 children with ametropia (372 eyes) served as the subjects of the study. The ametropic eyes of the patients were subjected to quick mydiasis by receiving mydrin-P eye drops every 5 min. for three times. Optometry was carried out 30 min after the last dropping . Call-back examination was performed on the next day after the pupils had reverted to the normal size. Beginning from the same day, the patients were given atropine eye drops t.i.d. for 3 consecutive days for their ametropic eyes. Optometry for these patients was once more performed on the 4~th day and call-back examination carried out 3 weeks later . Results Hyperopia accounted for the majority of ametropia(66.88%) in children below 10 years of age while myopia was more prevalent(64.15%) in children 10-14 years old. In children 10-14 years old who suffered from myopia ,the difference between the results of optometry after mydriasis induced by mydrin-P and atropin, as well as the difference between results of call-back examination after mydrin-P and atropine treatment ,was insignificant(P>0.05). These differences, however, were significant (P<0.01 or P<0.05) in patients with hyperopia who were 10-14 years old as well as in children under 10 years of age who had myopia or hyperopia. Conclusion Mydrin-P was shown to be an ideal drug for mydriatic optometry in children 10 -14 years old who suffered from myopia. However, in children younger than 10 years old suffering from myopia or hyperopia , as well as in children shown to have compound astigmatism as revealed by optometry following mydrin-P, atropin is indicated.