CAJ | 학술논문

目的探讨调节对近视性散光的可能影响及散光的变化对近距离工作的可能影响.方法横断面研究.序贯选取近视性散光者87例(166眼存在散光),检查其屈光不正度、远矫正下近视力(DCNVA)、视近(眼前40 cm)状态下的散光修正度及视近散光修正后的近视力(ACNVA).视近状态下散光的修正采用交义柱镜.对视远与视近状态下的散光度、视远与视近状态下散光轴位、DCNVA与ACNVA 三对数据的差值进行正态性检验,若服从正态分布则采用配对t检验进行分析,若不服从则采用配对秩和检验.对视近状态下和视远状态下散光的差异量与残余散光度之间进行相关性分析.结果视近与视远状态下散光度的差异具有统计学意义(Z=-5.32,P＜0.01),且视近时散光度呈增加的趋势；二者轴位的差异无统计学意义；DCNVA与ACNVA的差异具有统计学意义,且散光修正后视力有提高的趋势(Z=-5.74,P＜0.01).顺规、斜轴及低度散光(≤-1.00 D)者与总体趋势相一致,而逆规散光及散光度＞-1.00 D者不具有该趋势.结论人眼各子午线的调节不均衡使调节时散光发生改变,不同程度地影响着近视力,从而影响近距离工作,这于顺规、斜轴及低度散光患者更为明显.
목적 탐토조절대근시성산광적가능영향급산광적변화대근거리공작적가능영향.방법 횡단면연구.서관선취근시성산광자87례(166안존재산광),검사기굴광불정도、원교정하근시력(DCNVA)、시근(안전40 cm)상태하적산광수정도급시근산광수정후적근시력(ACNVA).시근상태하산광적수정채용교의주경.대시원여시근상태하적산광도、시원여시근상태하산광축위、DCNVA여ACNVA 삼대수거적차치진행정태성검험,약복종정태분포칙채용배대t검험진행분석,약불복종칙채용배대질화검험.대시근상태하화시원상태하산광적차이량여잔여산광도지간진행상관성분석.결과 시근여시원상태하산광도적차이구유통계학의의(Z=-5.32,P＜0.01),차시근시산광도정증가적추세；이자축위적차이무통계학의의；DCNVA여ACNVA적차이구유통계학의의,차산광수정후시력유제고적추세(Z=-5.74,P＜0.01).순규、사축급저도산광(≤-1.00 D)자여총체추세상일치,이역규산광급산광도＞-1.00 D자불구유해추세.결론 인안각자오선적조절불균형사조절시산광발생개변,불동정도지영향착근시력,종이영향근거리공작,저우순규、사축급저도산광환자경위명현.
Objective To analyze the existence of astigmatism with accommodation and its possible effect on near vision work.Methods It was a cross-sectional study.The refraction of 166 astigmatic eyes of 87 patients were measured at distance (at 5 m) and near (at 40 cm).The distance corrected near visual acuity (DCNVA) and accommodative astigmatism corrected near visual acuity (ACNVA) were measured with distance-corrected glasses and neas-corrected glasses,respectively,using near vision chart.The astigmatism at near was measured under monocular condition with crosscylinder lenses.The degree of astigmatism at far and near,the axis of astigmatism at far and near,DCNVA and ACNVA were compared by paired t test respectively if the data were normal distribution,if not,compared by Wilcoxon matched-pairs signed-ranks test.Analyzed the association between the astigmatism changes and residual astigmatism.Results The degree of astigmatism with accommodation and the near visual acuity when accommodative astigmatism corrected were both increased significantly (Z=-5.32,P＜0.01 ; Z=-5.74,P＜0.01),similar resulta were obtained in subjects had with-the-rule and oblique astigmatism and astigmatism ≤-1.00 D.But the axis showed no statistical significance.The astigmatism changes showed no significant association with residual astigmatism.Conclusion A change in astigmatism with accommodation does indeed exist,and sometimes affects near vision,especially for tbose who had with-the-rule and oblique astigmatism and astigmatism ≤-1.00 D.So optometrists should pay attention to the examination of near astignatism,especially for those who have near vision problems.