3种常用验光法在青少年屈光检查中的应用分析  

Accuracy of three common optometry methods in examination of refraction in juveniles

作　　者：苏婷[1] 闵晓珊[1] 刘双珍[1] 李凤云[1] 谭星平[1] 钟燕妮 邓少灵[1] 

机构地区：[1]中南大学湘雅医院眼科,长沙410008

出　　处：《中南大学学报（医学版）》2016年第2期174-181,共8页Journal of Central South University ：Medical Science

基　　金：湖南省科技厅一般项目(2012SK3201)~~

摘　　要：目的：使用视力筛查仪、电脑验光仪与视网膜检影等3种常用验光方法比较分析青少年屈光不正患者散瞳前后的检测结果。方法：对78例（156只眼）53~17岁青少年分别在自然瞳孔下应用Welch Allyn Suresight手持式视力筛查仪及NIDEK ARK-510A型自动电脑验光仪进行验光。充分睫状肌麻痹散瞳后,行视力筛查仪、电脑验光仪和视网膜检影3种验光法。结果：各方法散瞳前球镜代数值均低于散瞳后,数值更偏近视（P〈0.05）;散瞳前视力筛查仪与散瞳后的检影验光比较,球镜值、柱镜值和散光轴位差异均无统计学意义（P〉0.05）,两者的一致性优于电脑验光与视网膜检影,但是所得数值偏近视倾向;散瞳前电脑验光与检影验光比较,球镜值和柱镜值差异均有统计学意义（P〈0.05）;散瞳后视力筛查仪与检影验光比较,球镜值差异有统计学意义（P〈0.05）,而散瞳后电脑验光与检影验光比较,柱镜值差异有统计学意义（P〈0.05）。结论：对于青少年验光,睫状肌麻痹散瞳后检影验光必不可少。自然瞳孔下,视力筛查仪验光优于电脑验光,尤其在判断屈光不正的性质方面（球镜值更准）。但是两者都有高估近视程度的倾向。散瞳后,电脑验光准确性高于视力筛查仪,可作为试镜的参考。充分睫状肌麻痹散瞳后视网膜检影验光结合主观试镜仍是检查屈光不正最为有效的方法。Objective： To compare the results of the three methods of Suresight handheld autorefractor,table-mounted autorefractor and retinoscopy in examination of juveniles patients with or without cycloplegia.Methods： Firstly, 156 eyes of 78 juveniles（5 to 17 years old） were examined by using WelchAllyn Suresight handheld autorefractor and NIDEK ARK-510 A table-mounted autorefractor with or without cycloplegia; secondly, retinoscopy was performed with cycloplegia.Results： The spherical power measured by methods without cycloplegia were significantly greater than those measured with cycloplegia（P0.05）; without cycloplegia, there was no significant difference in spherical power, cylindrical power and cylindrical axis between Suresight handheld autorefractor and retinoscopy（P0.05）. These results were highly consistent, suggesting a tendency towards a short sight. However, the spherical power and cylindrical power measured by tablemounted autorefractor was significantly different（P0.05）; with cycloplegia, there was significant difference in spherical power between Suresight handheld autorefractor and retinoscopy（P0.05）.Conclusion： Cycloplegic retinoscopy is necessary for juvenile refraction examination. Under natural pupil situation, Suresight handheld autorefractor is bett er than table-mounted autorefractor,though both show a myopia tendency. Nevertheless, table-mounted autorefractor can be taken as a recommendation for the prescription of lens trial. As a strong reference for subjective optometry,retinoscopy should be the gold standard for measuring refractive errors.

关 键 词：屈光不正 青少年 电脑验光仪 检影验光 Suresight自动验光仪 视力筛查仪 睫状肌麻痹 

分 类 号：R778.2[医药卫生—眼科]