目的分析不同睫状肌功能状态下近视儿童青少年主观验光与电脑验光结果的差异。
方法采用队列研究方法，纳入2023年11月至2024年2月于上海市眼病防治中心就诊的7～15岁近视儿童青少年98例196眼的验光数据资料。使用1.0%环喷托酯滴眼液进行睫状肌麻痹，所有受试者均分别在睫状肌麻痹前、麻痹后和麻痹恢复后进行电脑验光和主观验光，比较不同睫状肌功能状态下等效球镜度(SE)和SE差值(ΔSE)。计算并比较不同睫状肌功能状态之间电脑验光与主观验光得到的ΔSE及球镜差值(ΔS)、柱镜差值(ΔC)处于可接受误差范围(-0.25～0.25 D)的比例。
结果睫状肌麻痹前、麻痹后和麻痹恢复后电脑验光得到的SE分别为-2.44(-3.47，-1.63)、-2.13(-3.25，-1.50)和-2.38(-3.50，-1.66)D，总体比较差异有统计学意义( χ 2＝148.36， P<0.001)，不同时间点两两比较差异均有统计学意义(均 P<0.001)。睫状肌麻痹前、麻痹后和麻痹恢复后主观验光得到的SE分别为-2.25(-3.50，-1.50)、-2.19(-3.47，-1.45)和-2.28(-3.50，-1.50)D，总体比较差异有统计学意义( χ 2＝43.48， P<0.001)，不同时间点两两比较差异均有统计学意义(均 P<0.001)。睫状肌麻痹前后、睫状肌麻痹后与麻痹恢复后主观验光ΔSE均明显小于电脑验光结果，差异均有统计学意义( t＝2.84、1.82，均 P<0.001)。睫状肌麻痹前与麻痹恢复后主观验光与电脑验光ΔSE比较，差异无统计学意义( t＝-0.43， P＝0.070)。睫状肌麻痹前后、睫状肌麻痹前与麻痹恢复后、睫状肌麻痹后与麻痹恢复后主观验光ΔSE处于可接受误差范围的比例均明显高于电脑验光，差异均有统计学意义( χ 2＝28.32、11.82、25.55，均 P<0.001)。睫状肌麻痹前与麻痹恢复后、睫状肌麻痹后与麻痹恢复后主观验光ΔS和ΔC均处于可接受误差范围的比例分别为81.63%(160/196)和79.59%(156/196)。
结论主观验光受不同睫状肌功能状态影响的程度较小。不同睫状肌功能状态下的主观验光结果差异大部分位于可接受误差范围内，可以使用睫状肌麻痹前或睫状肌麻痹后的主观验光结果较为准确地推测睫状肌麻痹恢复后的主观验光结果。
ObjectiveTo analyze the differences between subjective refraction and autorefraction in myopic children and adolescents under different ciliary muscle functional states.
MethodsA cohort study was conducted.A total of 98 myopic children and adolescents (196 eyes) aged 7-15 years who visited the Shanghai Eye Disease Prevention and Treatment Center from November 2023 to February 2024 were included by random sampling.All participants underwent cycloplegia with 1.0% cyclopentolate and completed both subjective refraction and autorefraction before cycloplegia, after cycloplegia and after recovery from cycloplegia.The spherical equivalent (SE) differences and differences in SE(ΔSE) between different conditions were compared.Proportion of ΔSE, differences in spherical power (ΔS), and differences in cylindrical power (ΔC) of objective and subjective refraction between different conditions within the clinically acceptable error range (-0.25 to 0.25 D) was calculated and compared.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Shanghai Eye Diseases Prevention & Treatment Center (No.2021SQ021).Written informed consent was obtained from guardian of each subject before any medical examination.
ResultsThe SE values obtained from autorefraction before cycloplegia, after cycloplegia, and after recovery from cycloplegia were -2.44(-3.47, -1.63), -2.13(-3.25, -1.50), and -2.38(-3.50, -1.66)D, respectively, with a statistically significant overall difference ( χ 2=148.36, P<0.001) and statistically significant differences in pairwise comparisons at different time points (all P<0.001); for subjective refraction, the SE values were -2.25(-3.50, -1.50), -2.19(-3.47, -1.45), and -2.28(-3.50, -1.50)D, respectively, with a statistically significant overall difference ( χ 2=43.48, P<0.001) and statistically significant differences in pairwise comparisons at different time points (all P<0.001).Subjective refraction ΔSE between before and after cycloplegia, after cycloplegia and after recovery from cycloplegia were significantly smaller than those of autorefraction ( t=2.84, 1.82; both P<0.001).There was no significant difference in ΔSE between subjective refraction and autorefraction between before cycloplegia and after recovery from cycloplegia ( t=-0.43, P=0.070).The proportions of subjective refraction ΔSE within the acceptable error range between before and after cycloplegia, before cycloplegia and after recovery from cycloplegia, and after cycloplegia and after recovery from cycloplegia were significantly higher than those of autorefraction ( χ 2=28.32, 11.82, 25.55; all P<0.001).The proportion of subjective refraction ΔS and ΔC both within the acceptable error range between before cycloplegia and after recovery from cycloplegia was 81.63%(160/196) and 79.59%(156/196) between after cycloplegia and after recovery from cycloplegia.
ConclusionsSubjective refraction is less affected by different ciliary muscle functional states.The differences in subjective refraction results under different ciliary muscle functional states are mostly within the acceptable error range.The subjective refraction results before or after cycloplegia can be used to better predict the subjective refraction results after recovery from cycloplegia.
黄馨慧,吴昊天,张波,等. 不同睫状肌功能状态下近视儿童青少年主观验光与电脑验光结果差异分析[J]. 中华实验眼科杂志,2025,43(02)：138-143.
DOI:10.3760/cma.j.cn115989-20240720-00202版权归中华医学会所有。
未经授权，不得转载、摘编本刊文章，不得使用本刊的版式设计。
除非特别声明，本刊刊出的所有文章不代表中华医学会和本刊编委会的观点。
黄馨慧：参与选题、研究设计、收集主要研究数据、文章撰写；吴昊天：参与研究设计、数据和资料分析、论文撰写及修改；张波、艾志建：研究实施、数据收集和整理；陈军：数据收集、统计分析；何鲜桂：参与选题、研究设计、研究过程指导、文章主要内容修改和定稿
文档即答
智问智答
机器翻译
你好，我可以帮助您更好的了解本文，请向我提问您关注的问题。
