Wang Xiao-ming, Ma Lu-xin, Wang Li-hua
Eye Center, Shandong Provincal Hospital Affiliated to Shandong University, Jinan 250021, China.
Zhonghua Yan Ke Za Zhi. 2011 Nov;47(11):989-94.
To investigate the peak time of refractive error obtained by Cyclopentolate Hydrochloride 1.0% (Cyclopentolate 1.0% for short) and Cyclopentolate 1.0% combined with Proparacaine Hydrochloride 0.5% (Proxymetacaine) and to compare the refractive error obtained by Cyclopentolate 1.0% and Atropine 1.0% in the children with hyperopia.
Seventy one children (141 eyes) with hyperopia (mean age 7.9 ± 2.1) were divided into two groups randomly according to the different cycloplegic methods:group A (Pro+Cyc group) and group B (NS+Cyc group). There were 34 patients (67 eyes) in group A and 37 patients (74 eyes) in group B. One drop of Proparacaine Hydrochloride 0.5% or physiological saline was used respectively in group A and group B, five minutes before three drops of Cyclopentolate 1.0% were given at intervals of ten minutes. Cycloplegic autorefraction and pupil diameter were compared at 30, 40, 50, 60, 70minutes after the first drop of Cyclopentolate 1.0% was given in both A and B groups. Atropine 1.0% was used in both groups one week later for three days with three times per day (group A' and group B'). Cycloplegic autorefraction and pupil diameter were compared between group A and A, ' and group B and B', respectively.
The peak time of cycloplegic autorefraction was 50 minutes after the first drop of cyclopentolate 1.0% in group A, while the peak time was 60 minutes in group B. The maximal cycloplegic autorefraction of group A was significantly lower than that in group A' [(+4.44 ± 2.34) D vs. (+4.86 ± 2.26) D, t = 11.16, P < 0.01]. The maximal cycloplegic autorefraction of group B was significantly lower than that in group B' [(+4.50 ± 2.19) D vs. (+5.04 ± 2.10) D, t = 11.44, P < 0.01]. The difference of cycloplegic autorefraction between group A' and the peak refraction of group A was less than the difference between group B' and the peak refraction of group B [(0.42 ± 0.32) D vs. (0.54 ± 0.39) D, t = -1.99, P = 0.048]. The peak time of pupil diameter is 50 minutes after the first drop of cyclopentolate 1.0% in group A, while the peak time of pupil diameter is 60 minutes in group B. The time course of cycloplegic was consistent with mydriasis.
In 3 to 14 years old Chinese hyperopia children, using cyclopentolate 1.0% three drops for optometry examination, the maximal cycloplegic autorefraction can be measured from 50 minutes to 70 minutes after the first drop of Cyclopentolate 1.0%. The Cyclopentolate 1.0% can achieve the peak time of refraction 10 minutes early as well as increase the effect of mydriasis when it is used combined with topical anaesthetic. Cyclopentolate 1.0% can be used for the optometry examination in the hyperopia children. However neither Cyclopentolate 1.0% nor Cyclopentolate 1.0% combined with Proparacaine Hydrochloride 0.5% can instead of the use of Atropine 1.0%.
探讨1.0%盐酸环喷托酯(以下简称1.0%环喷托酯)及1.0%环喷托酯联合0.5%盐酸丙美卡因(丙美卡因)散瞳验光获得屈光不正的峰值时间,并比较1.0%环喷托酯与1.0%阿托品在远视儿童中的散瞳验光结果。
将71例(141眼)远视儿童(平均年龄7.9±2.1岁)按不同散瞳方法随机分为两组:A组(丙美+环喷组)和B组(生理盐水+环喷组)。A组34例(67眼),B组37例(74眼)。A组和B组分别在滴用3次1.0%环喷托酯前5分钟,先分别滴用1次0.5%盐酸丙美卡因或生理盐水,然后每隔10分钟滴用1.0%环喷托酯1次。A、B两组在滴用第1次1.0%环喷托酯后30、40、50、60、70分钟分别进行散瞳电脑验光并测量瞳孔直径。1周后两组均改用1.0%阿托品点眼3天,每天3次(A'组和B'组)。分别比较A组与A'组、B组与B'组的散瞳电脑验光结果及瞳孔直径。
A组散瞳电脑验光的峰值时间为滴用第1次1.0%环喷托酯后50分钟,B组为60分钟。A组最大散瞳验光值显著低于A'组[(+4.44±2.34)D对(+4.86±2.26)D,t=11.16,P<0.01]。B组最大散瞳验光值显著低于B'组[(+4.50±2.19)D对(+5.04±2.10)D,t=11.44,P<0.01]。A'组与A组散瞳验光峰值的差值小于B'组与B组散瞳验光峰值的差值[(0.42±0.32)D对(0.54±0.39)D,t=-1.99,P=0.048]。A组瞳孔直径峰值时间为滴用第1次1.0%环喷托酯后50分钟,B组为60分钟。散瞳过程与瞳孔散大过程一致。
在3~14岁中国远视儿童中,采用1.0%环喷托酯3次散瞳验光检查,最大散瞳验光值在滴用第1次1.0%环喷托酯后50~70分钟可测得。1.0%环喷托酯联合表面麻醉剂使用时,可使屈光峰值时间提前10分钟,同时增强散瞳效果。1.0%环喷托酯可用于远视儿童散瞳验光检查。然而,1.0%环喷托酯及1.0%环喷托酯联合0.5%盐酸丙美卡因均不能替代1.0%阿托品的使用。