近视性屈光参差患者的相对调节反应对屈光手术Nomogram设计值的影响  

Effect of relative accommodation responses on Nomogram design value in patients with myopic anisometropia

作　　者：梁爽 王雁[1,2] 张琳[2] 李梦迪 赵新恒 LIANG Shuang;WANG Yan;ZHANG Lin;LI Mengdi;ZHAO Xinheng(Clinical College of Ophthalmology,Tianjin Medical University,Tianjin 300020,China;Tianjin Eye Hospital,Tianjin Eye Institute,Tianjin Key Laboratory of Ophthalmology and Visual Science,Tianjin 300020,China)

机构地区：[1]天津医科大学眼科临床学院,天津市300020 [2]天津市眼科医院,天津市眼科研究所,天津市眼科学与视觉科学重点实验室,天津市300020

出　　处：《眼科新进展》2022年第8期622-625,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金项目(编号:81873684)。

摘　　要：目的探讨近视性屈光参差患者的相对调节反应对屈光手术Nomogram设计值的影响。方法选取2020年6月至9月在天津市眼科医院屈光手术中心拟行近视性屈光不正患者62例(124眼)作为研究对象。根据双眼等效球镜度将患者分为高度数眼与低度数眼,进一步依据有无屈光参差将患者分为非屈光参差组高度数眼(HNA组,34眼)、非屈光参差组低度数眼(LNA组,34眼)、屈光参差组高度数眼(HA组,28眼)、屈光参差组低度数眼(LA组,28眼)。采用WAM-5500开放式自动验光仪进行眼调节反应测量,分别测量50 cm、40 cm、33 cm、25 cm、20 cm处对应的2.00 D、2.50 D、3.00 D、4.00 D、5.00 D调节刺激下的相对调节反应。术前Nomogram值、不同调节刺激下的相对调节反应采用Mann-Whitney U检验进行组间比较。结果LNA组、HNA组、LA组和HA组患者相对调节反应均小于其对应的调节刺激。HNA组患者2.00 D调节刺激下相对调节反应明显高于LA组,差异有统计学意义(P=0.038);HNA组患者5.00 D调节刺激下相对调节反应明显高于LA组,差异有统计学意义(P=0.009);2.50 D、3.00 D、4.00 D调节刺激下两组患者的相对调节反应差异均无统计学意义(均为P>0.05)。在LNA组和HNA组、LNA组和LA组、LNA组和HA组、HNA组和HA组、LA组和HA组患者不同调节刺激下的相对调节反应差异均无统计学意义(均为P>0.05)。在LA组中,5.00 D调节刺激下相对调节反应与术前Nomogram设计值呈正相关关系(r=0.444,P=0.020);在LNA组和HNA组中,术前Nomogram设计值与2.00 D、2.50 D、3.00 D、4.00 D和5.00 D调节刺激下相对调节反应均无明显相关性(均为P>0.05)。结论屈光参差患者术前相对调节反应会对Nomogram设计值产生影响,未来可根据患者术前相对调节反应适当调整术前Nomogram设计值以提高矫正效果。Objective To investigate the effect of relative accommodation response on Nomogram design value in myopic anisometropia.Methods Totally 62 patients(124 eyes)with myopic ametropia treated at the Refractive Surgery Center of Tianjin Eye Hospital from June to September 2020 were enrolled in this study.Based on the spherical equivalent(SE)of both eyes,patients were divided into the high and low SE groups and further divided into the high non-anisometropia(HNA)group(34 eyes),low non-anisometropia(LNA)group(34 eyes),high anisometropia(HA)group(28 eyes),and low anisometropia(LA)group(28 eyes)according to anisometropia.The relative accommodation responses were measured at 50 cm,40 cm,33 cm,25 cm,and 20 cm under 2.00 D,2.50 D,3.00 D,4.00 D,and 5.00 D stimuli,respectively,using the WAM-5500 open-ended automated optometer.Preoperative Nomogram design values and relative acco-mmodation responses under different stimuli were compared among the groups using the Mann-Whitney U test.Results The relative accommodation responses of patients in the LNA,HNA,LA,and HA groups were lower than the corresponding accommodation stimuli.The relative accommodation response under the 2.00 D stimulus in the HNA group was significantly higher than that in the LA group(P=0.038).The relative accommodation response under the 5.00 D stimulus in the HNA group was significantly higher than that in the LA group(P=0.009).There were no significant differences in relative accommodation responses at 2.50 D,3.00 D and 4.00 D between the HNA and LA groups(all P>0.05).The relative accommodation responses showed no significant difference under different stimuli between the LNA and HNA groups,LNA and LA groups,LNA and HA groups,HNA and HA groups,LA and HA groups(all P>0.05).In the LA group,the relative accommodation response at 5.00 D was positively correlated with the preoperative Nomogram design value(r=0.444,P=0.020),but in the LNA and HNA groups,the relative accommodation responses at 2.00 D,2.50 D,3.00 D,4.00 D,and 5.00 D showed no correlation with the pr

关 键 词：近视 屈光参差 相对调节反应 Nomogram设计值 

分 类 号：R778[医药卫生—眼科]