Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
Department of Ophthalmology, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2019 Jan 21;34(4):e32. doi: 10.3346/jkms.2019.34.e32. eCollection 2019 Jan 28.
To objectively investigate accommodative response to various refractive stimuli in subjects with normal accommodation.
This prospective, non-randomized clinical trial included 64 eyes of 32 subjects with a mean spherical equivalent -1.4 diopters (D). We evaluated changes in accommodative power, pupil diameter, astigmatic value, and axis when visual stimuli were applied to binocular, monocular (dominant eye, non-dominant eye, ipsilateral, and contralateral), and pinhole conditions. Visual stimuli were given at 0.25 D (4 m), 2 D (50 cm), 3 D (33 cm), and 4 D (25 cm) and accommodative response was evaluated using open view binocular autorefractor/keratometer.
The accommodative response to binocular stimulus was 90.9% of the actual refractive stimulus, while that of the monocular stimulus was 84.6%. The binocular stimulus induced a smaller pupil diameter than did the monocular stimulus. There was no difference in accommodative response between the dominant eye and non-dominant eye or between ipsilateral and contralateral stimuli. As the refractive stimuli became stronger, the absolute astigmatic value increased and the direction of the astigmatism axis became more horizontal. Pinhole glasses required 10%-15% less accommodative power compared with the monocular condition.
Binocular stimuli enable more precise and effective accommodation than do monocular stimuli. Accommodative response is composed of 90% true accommodation and 10% pseudo-accommodation, and the refractive stimulus in one eye affects the contralateral eye to the same extent. This should be taken into account when developing guidelines for wearing smart glasses while driving, as visual stimulation is applied to only one eye, but far distance attention is constantly needed.
ClinicalTrials.gov Identifier: NCT03557346.
客观研究正视眼对各种屈光刺激的调节反应。
本前瞻性、非随机临床试验纳入 32 名受试者的 64 只眼，平均等效球镜度为-1.4 屈光度（D）。我们评估了双眼、单眼（主导眼、非主导眼、同侧和对侧）和小孔条件下，视觉刺激作用于双眼时，调节力、瞳孔直径、散光值和轴位的变化。在 0.25 D（4 m）、2 D（50 cm）、3 D（33 cm）和 4 D（25 cm）处给予视觉刺激，并使用开眼双眼自动验光仪/角膜曲率计评估调节反应。
双眼刺激的调节反应为实际屈光刺激的 90.9%，而单眼刺激的调节反应为 84.6%。双眼刺激引起的瞳孔直径小于单眼刺激。主导眼和非主导眼或同侧和对侧刺激之间的调节反应没有差异。随着屈光刺激的增强，绝对散光值增加，散光轴方向变得更加水平。与单眼状态相比，小孔眼镜需要的调节力减少 10%-15%。
与单眼刺激相比，双眼刺激能更精确有效地调节。调节反应由 90%的真实调节和 10%的假性调节组成，一只眼的屈光刺激对对侧眼的影响相同。这在制定戴智能眼镜驾驶的指南时应予以考虑，因为只有一只眼睛受到视觉刺激，但需要不断关注远距离。
ClinicalTrials.gov 标识符：NCT03557346。
