Ismail E E, Rouse M W, De Land P N
Southern California College of Optometry, Fullerton.
Optom Vis Sci. 1994 Apr;71(4):235-41. doi: 10.1097/00006324-199404000-00001.
We compared the objective cycloplegic refractive error of 37 hyperopic children (ages 18 months to 6 years). Cycloplegia was by spray application to the closed eye, or by a one-drop instillation to the open eye. Patients were initially screened for hyperopia using a masked noncycloplegic retinoscopy with loose trial lenses. Spray and drop cycloplegias (1% cyclopentolate hydrochloride; 1% Spectro Pentolate) were administered to each patient in random order within a 2-week period. A masked cycloplegic retinoscopy was performed 20 min after drug administration for patients with "light" iris coloration and after 40 min for those with "dark" irides. One examiner conducted all cyclopentolate administrations; a separate examiner (masked to application method) conducted all refractive testing. For right eyes, the mean spherical equivalent refractive error after spray application was 1.76 D (SD = 1.63 D) and after drop instillation 1.78 D (SD = 1.85 D). Results were similar for the left eyes. These small differences were not statistically significant (ANOVA, F = 0.05, p = 0.82). The absolute difference in spherical equivalent was 0.50 D or less in 93% of all subject eyes. A scaling system was used to rate the ease of administration and the patient's response to each method. Using an exact test of marginal homogeneity, the response rating for the spray method was significantly better (p = 0.038). The spray application of cyclopentolate hydrochloride is easier to administer and is an effective alternative to traditional drop instillation.
我们比较了37名远视儿童（年龄在18个月至6岁之间）的客观睫状肌麻痹验光结果。睫状肌麻痹通过向闭合的眼睛喷雾给药，或向睁开的眼睛滴一滴眼药水来实现。最初使用带有松散试验镜片的遮盖式非睫状肌麻痹检影法对患者进行远视筛查。在2周内，以随机顺序对每位患者分别给予喷雾和滴眼睫状肌麻痹剂（1%盐酸环喷托酯；1%斯佩克特戊酯）。对于虹膜颜色较“浅”的患者，在给药后20分钟进行遮盖式睫状肌麻痹检影；对于虹膜颜色较“深”的患者，则在40分钟后进行。所有环喷托酯给药均由一名检查者进行；另一名检查者（对给药方法不知情）进行所有验光测试。右眼在喷雾给药后的平均球镜等效屈光度为1.76 D（标准差 = 1.63 D），滴眼给药后为1.78 D（标准差 = 1.85 D）。左眼的结果相似。这些微小差异无统计学意义（方差分析，F = 0.05，p = 0.82）。在所有受检眼的93%中，球镜等效度的绝对差异为0.50 D或更小。使用一个评分系统来评估给药便利性和患者对每种方法的反应。通过精确的边际同质性检验，喷雾法的反应评分明显更好（p = 0.038）。盐酸环喷托酯喷雾给药更易于操作，是传统滴眼给药的有效替代方法。
