【作者】 马鹤；

【导师】 亢晓丽；

【作者基本信息】 中国医科大学 ， 眼科学， 2004， 硕士

【摘要】 目的 找出美多丽-P滴眼液、罗米滴眼液的最大睫状肌麻痹时间，对比美多丽-P滴眼液、罗米滴眼液、1％阿托品眼膏最大睫状肌麻痹时的剩余调节力，并分析三种药物对屈光不正检测的影响。为眼科临床合理应用睫状肌麻痹剂提供一定的实验依据。 方法 对4～16岁儿童75人、147眼进行检查，其中男32人，女43人，平均年龄10.12岁。均未曾配戴过眼镜，未曾屈光治疗，其裸眼或矫正视力均可达1.0，并除外其他眼病及影响调节的全身病。分三组：A组1％阿托品眼膏组、B组罗米滴眼液组、C组美多丽-P滴眼液组。对各组睫状肌麻痹前后不同时间点(A组涂药前及涂完药后次日；B组滴药前及滴完药后5分钟、30分钟、60分钟、90分钟、120分钟；C组滴药前及滴完药后5分钟、30分钟、60分钟、90分钟)，分别进行手持自动电脑验光仪客观验光、综合验光仪主观验光及视网膜检影验光。在综合验光仪上使用调节尺及调节卡，采用移近法测量调节力及剩余调节力。 结果 1、罗米滴眼液组最大睫状肌麻痹时间为60分钟。次日可以正常阅读。美多丽-P滴眼液组最大睫状肌麻痹时间为30分钟，次日可以正常阅读。 2、最大睫状肌麻痹时的平均剩余调节力为：1％阿托品组2.0440±0.95484D，罗米滴眼液组2.2214±0.6952D，美多丽-P滴眼液组2.6656±0.9999D。两独立样本T检验前两组无显著差异，p＞0.05。美多丽-P滴眼液组与前两组差异显著，p＜0.05，尤其近视时剩余调节力偏大。 3、三组剩余调节力均与屈光状态及年龄无关。 4、1％阿托品眼膏、罗米滴眼液、美多丽-P滴眼液三组中每组药物最大睫状肌麻痹后，综合验光仪验光、视网膜检影结果无差别，P>0.05，都能达到主、客观验光结果的一致性。 5、三种药各自睫状肌麻痹前后屈光度变化差值，1%阿托品眼膏组最大，平均为0.sll0D，在远视屈光状态三组无明显差异(一0.5714-一1.4375D)，在近视屈光状态(一0.0639一0‘3《X珍D)罗米滴眼液组较小，与1%阿托品组相比相差小于0.25D。结论 1、罗米滴眼液最大睫状肌麻痹时间是60分钟，美多丽一P滴眼液最大睫状肌麻痹时间是30分钟。 2、剩余调节力1%阿托品眼膏最小，罗米滴眼液与1%阿托品眼膏相似，美多丽一P滴眼液与前二者相比偏大。 3、美多丽一P滴眼液、1%阿托品眼膏、罗米滴眼液达到最大睫状肌麻痹后，都能达到综合验光仪主观验光与视网膜检影客观验光结果的一致性，都能起到充分麻痹睫状肌的作用。 4、罗米滴眼液、美多丽一P滴眼液在临床上可以作为近视儿童及无斜视弱视的远视儿童验光的有效睫状肌麻痹剂。次日可以正常阅读，应用更为方便。更多还原

【Abstract】 To find out the longest effective duration of Mydrin - P and Romi eyedrop on cycloplegia, compare the residual accommodation after cycloplegia by Mydrin - P eyedrop, 1 % Atropine past and Romi eyedrop, analye their effect on ame-tropia. To provide some experiment basis for using cycloplegia properly in clinic.Methods75 children(147eyes) were checked , 4 ~ 16 years, male 32, female 43, mean age : 10.12 years. No organic disease. The patients divided into 3 group: A, 1 % Atropine group; B, Romi eyedrop group and C, Mydrin - P group. Before and after administration of these eyedrops, objective refrection was checked in hand -hold auto refrator; subjective refrection was checked in phoropter, and retinoscopy refraction was finished. Phoropter was used to check the accommodation response and the residual accommodation respectively by " pushup" method.Results1. In Romi eyedrop group , the time of maximum cycloplegia was 60 minutes , the patients can read in the next day ; In Mydrin - P group , the timewas 30 minutes , can read next day.2. Average residual accommodation at the maximum cycloplegia: A, 1% Atropine group 2. 0440 # 0. 95484D , B, Romi eyedrop group 2. 2214 # 0. 6952D, C, Mydrin -P group 2.6656 #0.9999D. The residual accommodation in Romi eyedrop and Atropine groups has no significant difference, Independent- samples T Test p > 0. 05. The residual accommodation in Mydrin - P group was stronger than the other two groups , more significant in myopia eyes.3. Three groups residual accommodation have no relationship with age and refrective status.4. The results were same in cycloplegic refraction with objective retinosco-py and subjective phoropter of each groups of A, 1 % Atropine group, B, Romi eyedrop group and C, Mydrin - P group . ( p > 0.05 )5. Diopter difference of three group before and after cycloplegic refraction, was same in hyperopia, which of Romi eyedrop group was smaller less than 0. 25 D compared with 1% Atropine group in myopia.Conclusions1. The time of maximum cycloplegia effective of Romi eyedrop was 60 minutes , of Mydrin - P was 30 minutes.2. The residual accommodation in Romi eyedrop and Atropine groups was almost same , the residual accommodation in Mydrin - P group was stronger than the other two -groups, more significant in myopia eyes.3. There was no significant difference in the refraction change between groups before and after the administration of these 3 kinds eyedrop. They can all fully cycloplegia.4. Romi eyedrop , Mydrin - P eyedrop can be use in the cycloplegic refraction for children in myopia and hyperopia without strabismus and amblyopia.更多还原