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目的探讨眼局部应用1%阿托品对儿童共同性内斜视斜视角度、调节性集合和双眼视功能的影响。设计前瞻性临床研究。研究对象共同性内斜视患者35例(3～15岁)。方法1%阿托品眼用凝胶进行散瞳验光前、后分别进行斜视角度、调节性集合/调节(AC/A)、双眼视觉测定,并根据验光结果分为≤+3 D、>+3 D并≤+6 D和>+6 D三个不同屈光度组,对其散瞳前后的各项指标变化进行分析。主要指标斜视角度(三棱镜度)、AC/A、同时知觉、融合功能、远立体视觉、近立体视觉。结果3组患者中斜视角度≤50~Δ和≥55~Δ的患者分布无显著性差异(χ~2=0.52,P=0.77);14例≤3 D患者中散瞳后的斜视角度无变化者11例(78.57%),斜视角度减小者仅2例(14.29%),而11例>3 D并≤6 D患者和10例>6 D患者中散瞳后斜视角度减小者均为5例(分别为45.46%和50.00%)。三组患者中,散瞳前AC/A的分布无显著性差异(χ~2=4.87,P=0.30)。散瞳后各组AC/A均有减小的趋势,变化无显著性差异(χ~2=1.89,P=0.75)。5例具有不同程度双眼视觉者,其斜视角度均≤20~Δ。结论在儿童共同性内斜视中,低度远视患者散瞳前后斜视角度无明显变化,部分中、高度远视患者散瞳后斜视角度有减小趋势。
Objective To investigate the effect of topical application of 1% atropine on the children with esotropia, accommodative set and binocular visual function. Design prospective clinical studies. Thirty-five patients (3-15 years) with esotropia were studied. Methods 1% atropine ophthalmic gel was used for mydriatic optometry before and after, respectively, for strabismus, accommodative regulation / acuity (AC / A) and binocular visual acuity. According to the result of optometry, it was classified as ≤ +3 D,> +3 D And ≤ + 6 D and> +6 D three different diopter groups, the mydriasis before and after changes in the indicators were analyzed. Main indicators Strabismus angle (prism), AC / A, simultaneous perception, fusion function, far stereoscopic vision, near stereoscopic vision. Results There was no significant difference (χ ~ 2 = 0.52, P = 0.77) in patients with squint angle ≤50 ~ Δ and ≥55 ~ Δ in 3 groups. There was no change in strabismus angle in 14 patients ≤3D 11 cases (78.57%), only 2 cases (14.29%) with reduced strabismus angle, and 11 cases> 3 D and 6 D patients and 10 cases> 6 D patients 5 cases (45.46% and 50.00% respectively). Among the three groups, there was no significant difference in the distribution of AC / A before dilation (χ ~ 2 = 4.87, P = 0.30). After mydriasis, the AC / A of all groups showed a trend of decreasing, with no significant difference (χ ~ 2 = 1.89, P = 0.75). Five patients with different degrees of binocular vision, the strabismus angle ≤ 20 ~ Δ. Conclusions In pediatric esotropia, there is no significant change in squint angle before and after mydriasis in some patients with mild hyperopia. In some children with hyperopia, the squint angle tends to decrease after dilation.