睫状肌麻痹后散光显著增加2例诊疗分析  

Significant Increase in Astigmatism after Cycloplegia in Two Children

作　　者：杨必[1] 刘陇黔[1] YANG Bi;LIU Long-qian(Department of Ophthalmology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院眼科,成都610041

出　　处：《四川大学学报（医学版）》2020年第5期725-728,共4页Journal of Sichuan University(Medical Sciences)

基　　金：成都市科技局技术创新研发项目(No.2019-YF05-00209-SN)资助。

摘　　要：本文报道2例高度角膜散光、且为混合散光患儿在睫状肌麻痹后验光均出现散光显著增加。结合患儿眼屈光性质、角膜地形图及像差分析,提出瞳孔直径改变带来的像差变化、不同直径范围的角膜散光差异、睫状肌麻痹前后晶体散光的改变均可能导致睫状肌麻痹后散光增加。我们发现,对于高度角膜散光,尤其是混合散光的儿童,睫状肌麻痹验光结果不一定能精确反映患儿日常生活中的屈光状态。由于患儿需要的是自然瞳孔状态下的屈光矫正,因此,我们建议,不能直接采用睫状肌麻痹后的验光结果作为此类患儿的配镜处方,需结合角膜地形图,参考自然瞳孔状态下的复光结果制定最终的配镜处方。Two cases with high corneal astigmatism and mixed astigmatism were reported. Both cases showed significantly increased astigmatism after cycloplegia. Combined with the patients’ refractive error, corneal topography and wavefront aberration changes, the possible causes were analyzed. Aberration changes caused by pupil dilation, corneal astigmatism differences in different diameter ranges, and changes in lens astigmatism before and after cycloplegia may lead to increased astigmatism after cycloplegia. It was found that cycloplegic refraction may not accurately reflect the refractive status in daily life for children with high corneal astigmatism, especially mixed astigmatism. Because children need refractive correction in the state of natural pupil, it is recommended that the cycloplegic refraction result could not be directly used as prescription for such children. The final prescription should be based on the topography and the refraction result under natural pupil.

关 键 词：睫状肌麻痹 散光 混合散光 验光 

分 类 号：R778.13[医药卫生—眼科]