托吡卡胺和阿托品对儿童散瞳验光应用价值的对比研究

目的探讨阿托品和托吡卡胺在儿童散瞳验光中的使用价值及对准确性的影响。方法儿童视力低常患者123例（246眼）,年龄4～12岁。按年龄分为两组,4～7岁组63例（126眼）,8～12岁组60例（120眼）。两组患者先用0.5%托吡卡胺散瞳,然后用NIDEKAR-600A电脑验光初测;第2天再用1%阿托品眼液滴眼,每日3次,连用3d,然后用同一电脑验光仪验光。分别记录两种方法散瞳后的验光结果,对比屈光度变化,采用SPSS11.0统计软件进行分析。结果托吡卡胺散瞳后,近视球镜均值比阿托品散瞳值高,远视球镜均值比阿托品值低,两组经配对t检验显示,差异有统计学意义（P＆lt;0.05）;柱镜均值与轴向均值经配对t检验显示,差异均无统计学意义（P＆gt;0.05）。两个不同年龄组等效球镜均值比较,不同散瞳方法差异有统计学意义（P＆lt;0.05）,托吡卡胺组等效球镜值均低于阿托品组。结论托吡卡胺用于儿童验光不是理想的选择,托吡卡胺不能代替阿托品。

Comparison of tropicamide and atropine for refraction test in children

Objective To compare the effects of tropicamide and atropine on children for mydriatic refraction test and to evaluate their value and accuracy.Methods One hundred and twenty-three children（246 eyes） with subnormal visual acuity aged 4～12（8.3± 1.8） were selected.The patients were divided into two groups based on age（4～8 years and 8～12 years）.After cycloplegia was applied with tropicamide,autorefraction was performed with a NIDEK AR-600A unit in their initial visit.In the next day visit,an atropine ophthalmic solution was applied three times a day,for three days,when refraction was performed with the same auto-refractor.The results were analyzed with SPSS 11.0 software.Results The average spherical values of tropicamide were more myopic in the myopic children than with atropine.A matched-pairs t-test showed that there was a significant difference（P〈0.05）.The average spherical values of atropine were more hyperopic in hyperopic children than with tropicamide.A matched-pairs t-test showed that there was a significant difference（P〈0.05）.The results for cylinder and axis were not significantly different（P〉0.05）.The average equivalent sphere values for the two age groups were significantly different not only with age,but also with tropicamide and atropine（P 〈0.05）.Conclusion The use of tropicamide for refraction test among children is not an ideal option.Tropicamide cannot replace atropine for refraction test in children.