青少年屈光不正眼屈光度与角膜曲率及眼轴的相关性

李娟曾锦崔颖谢文娟廖伟雄欧碧群

【摘要】目的探讨屈光不正青少年角膜曲率、眼轴与屈光度的关系。方法选取屈光不正患者43例82眼。按等效球镜度分成2组：远视组(21例41眼)、近视组(22例41眼)。测量其屈光度、角膜水平曲率半径、角膜垂直曲率半径及眼轴，并对其进行统计学分析。结果2组屈光不正患者角膜水平曲率半径、角膜垂直曲率半径、眼轴及眼轴/角膜曲率半径比较，差异有统计学意义(P<0.05)。2组屈光不正患者屈光度与眼轴及眼轴/角膜曲率半径均具有线性相关关系(r远视组=-0.544,-0.310；r近视组=-0.558,-0.790,P<0.05)。2组屈光不正患者眼轴与角膜水平曲率半径及角膜垂直曲率半径均具有线性相关关系(r远视组=0.572,0.668；r近视组=0.587,0.551,P<0.05)。2组屈光不正患者角膜水平曲率半径与角膜垂直曲率半径均具有线性相关关系(r远视组=0.937,r近视组=0.970,P<0.05)。结论屈光不正青少年屈光度与角膜曲率及眼轴长度密切相关，眼轴长度是近视形成的主要因素，眼轴/角膜曲率半径是监控近视进展的敏感指标。

【关键词】屈光不正；眼轴；角膜曲率；屈光度

收稿日期：(2015-05-06)

DOI：10.3969/g.issn.0253-9802.2015.10.007

通讯作者，曾勉，E-mail：zengmian2004@163.com

Correlation among the diopter, corneal curvature and axial length in adolescent with ametropiaLiJuan,ZengJin,CuiYing,XieWenjuan,LiaoWeixiong,OuBiqun.GuangdongGeneralHospital,Guangzhou510080,China

Correspondingauthor,ZengJin,E-mail:13710678633@139.com

Abstract【】ObjectiveTo investigate the correlation among the corneal curvature, axial length, and diopter in the adolescents with ametropia. MethodsForty three teenagers diagnosed with ametropia (82 eyes) were selected in this study. All participants were divided into the hyperopia (n=21, 41 eyes) and myopia (n=22, 41 eyes) groups according to the spherical equivalent (SE). The diopter, radii of horizontal and vertical corneal curvature and axial length were measured and statistically compared between two groups. ResultsThe radii of horizontal and vertical corneal curvature, axial length and axial length/radius of corneal curvature significantly differed between two groups (all P<0.05). In both groups, the diopter showed linear correlation with the axial length and axial length/radius of corneal curvature (rHyperopia=-0.544 and -0.310; rMyopia=-0.558 and 0.790, both P<0.05). Linear correlation was equally observed among the axial length and radii of horizontal and vertical corneal curvature in two groups (rHyperopia=0.572 and 0.668; rMyopia=0.587 and 0.551, both P<0.05). The radius of horizontal corneal curvature had linear correlation with that of vertical corneal curvature in both groups (rHyperopia=0.937, rMyopia=0.970, both P<0.05). ConclusionsIn the adolescents with ametropia, the diopter was closely correlated with the corneal curvature and axial length. The axial length was the main factor of the incidence of myopia. The axial length/radius of corneal curvature was a sensitive indicator to monitor myopic progression

【Key words】Ametropia; Axial length; Corneal curvature; Diopter

人类眼球的屈光状态受许多因素影响，其中主要因素有角膜及晶体系统、眼轴、前房深度等。一般认为，角膜屈光力和眼轴长度是其中两个主要因子[1]。本文通过对屈光不正青少年屈光度与角膜曲率和眼轴之间进行相关分析，探讨影响近视形成的因素，从而为近视发生的预防和控制提供依据。

对象与方法

一、研究对象

选择2014年8月至2015年4月在我院眼科中心就诊的屈光不正患者45例84眼。远视患者：等效球镜>0 D,柱镜≤1.0 D；近视患者：等效球镜<0 D,柱镜≤1.0 D。屈光不正患者(84眼)按等效球镜度分成2组：远视组22例42眼，男12例22眼，女10例20眼，年龄7.00(2.00)岁，屈光度1.000(1.125)D；近视组23例42眼，男11例21眼，女12例21眼，年龄12.00(5.00)岁，屈光度-2.250(1.375)D。所有受检者均排除具有眼部手术史、外伤史、活动性病变、严重眼表疾病、角膜瘢痕、不规则散光及眼压异常。本研究遵循赫尔辛基宣言。详细告知患者家长研究内容及相关风险，并签署知情同意书。

二、 检查方法

所有受检者均接受眼部检查：视力检查，非接触式眼压计检查，裂隙灯眼前节及眼底检查。筛选符合入选标准者。屈光检查中8岁以上青少年采用托品酰胺快速散瞳视网膜检影验光，3～8岁儿童采用阿托品眼膏散瞳检影验光。应用IOL-Master(Zeiss，德国)对受试者的眼轴长度和角膜曲率半径进行测量。眼轴长度需重复测量检测5次，其平均值作为统计的参数；角……