儿童混合性散光的屈光演变规律

目的 探讨儿童混合性散光的屈光演变规律。方法 选择4～9岁混合性散光儿童38例66眼，每年予1％阿托品扩瞳检影验光1次，连续4年，记录屈光状态，分析其等效球镜、远视、近视屈光度及散光度的动态变化。结果 儿童混合性散光绝大多数为顺规散光，经扩瞳检影、配镜可获得较好的矫正视力，视力〉0．6。随访4年，患儿等效球镜及远视主径线的屈光度逐年降低（P〈0．01），近视主径线的屈光度逐年加深（P〈0．01），散光度及轴位基本保持稳定不变（P〉0．05）。结论 儿童混合性散光可能是儿童屈光系统发育过程中的一个特定阶段，随着儿童年龄的增长，多可演变为近视散光，在儿童期，应密切随访，及时、正确地配镜矫正，以提高乖改善儿童视功能。

Trends in refractive error changes in children with mixed astigmatism

Objective To assess trends in refractive error changes in children with mixed astigmatism.Methods Thirty-eight patients with mixed astigmatism between 4 and 9 years of age(66 eyes) were examined annually over a 4-year period with cycloplegic retinoscopy after administering 1% atropine.Refractive status data were collected and trends of in refractive error changes were analyzed,including spherical equivalence and astigmatism.Results Most children with mixed astigmatism had with-the-rule astigmatism.Visual defects caused by mixed astigmatism can be satisfactorily corrected with spectacles,and the average best-corrected visual acuity was better than 0.6.The spherical equivalent hyperopic refractive values decreased and myopic refractive values increased each year(P<0.01),but astigmatic values and the axis remained stable over time(P>0.05).Conclusion Refractive error with mixed astigmatism mainly occurs in children, and these children can change to simple myopic astigmatism as their age.