【摘要】 目的 探讨不同屈光度及不同龄段的成年屈光不正患者睫状肌麻痹前后验光及复验光屈光度的变化；探讨电子产品盛行时代，成年屈光不正患者配镜是否需要散瞳验光。方法 回顾性分析1039只成年患者的眼屈光资料，将同一患者的显然验光、散瞳验光及散瞳验光后复验光的球镜及柱镜结果进行比较，并按年龄及屈光度进一步分组，分组后再次进行三种不同主观验光方法球镜及柱镜差异的比较。结果 1039只眼的平均球镜度数显然验光、散瞳验光及散瞳后复验光的结果分别为-4.77±2.00D、-4.55±2.01D及-4.56±1.99D，平均柱镜度数显然验光、散瞳验光及散瞳后复验光的结果分别为-0.91±0.86D、-0.95±0.85D及-0.95±0.83D，三者的差异且有统计学意义（P<0.05）。两两比较，发现显然验光与散瞳验光的球柱镜结果及显然验光与散瞳后复验光的球柱镜结果差异具有统计学意义。按年龄分为4组后，各组三种不同验光方法的球柱镜值分析显示，除>40岁组柱镜结果差异无统计学意义外，其他组三种验光结果的球柱镜值及>40岁组的球镜值差异具有统计学意义。按屈光度分为4组后，-3.01D～-6.00D组三种不同验光方法的球柱镜值、0～3.00D和>-6.00D组三种不同验光方法的球镜值结果差异具有统计学意义。球镜度数的差值有统计学意义的绝对值为0.17D～0.29D，柱镜度数的差值有统计学意义的绝对值为0.04D～0.07D。结论 成年近视屈光不正患者，应用三种不同主观验光方法验光，球柱镜的差异虽然具有统计学意义，但在临床验光配镜中该差异并无临床意义。因此，在当下环境里，一般人群在由经过正规训练的专业视光师使用综合验光仪进行物理睫状肌松弛后，在小瞳孔下进行规范的显然验光及试戴，也可得出准确的屈光度数。更多还原

【Abstract】 AIM To investigate the changes of refraction in adult patients with ametropia before and after ciliary paralysis and re-refraction under the small pupil next day. To explore whether the pupil should be dilated before refraction in adult patients with ametropia in the new era of more electronic products. METHODS The ocular refractive data of 1039 adult eyes was retrospectively analyzed, and the spherical and cylindrical diopter results of manifest refraction,mydriatic refraction and re-refraction under the small pupil next day in the same patient were compared. The group was further divided according to age and refraction, and the spherical and cylindrical diopters of the three subjective methods were compared respectively. RESULTS In 1039 eyes, the spherical diopters of manifest refraction,mydriatic refraction and re-refraction under the small pupil next day were -4.77± 2.00 D,-4.55± 2.01 D and-4.56± 1.99 D, respectively. The cylindrical diopters of the above three methods were-0.91± 0.86 D,-0.95± 0.85 D and-0.95±0.83 D, respectively. The difference among the three methods was statistically significant both in spherical and cylindrical diopters(P < 0.05).The pairwise comparison showed that there were statistically significant differences between the spherical and the cylindrical results of manifest refraction and mydriatic refraction. So were the manifest refraction and re-refraction under the small pupil next day. After being divided into four groups according to age, the spherical and cylindrical diopters of three different refraction methods in each group showed statistically significant differences except the cylindrical diopters of > 40 group. After being divided into four groups according to diopter, the spherical and cylindrical diopters in-3.01～-6.00 D group and the spherical diopters in 0～-3.00 D and-3.01～-6.00 D groups of three different refraction methods showed statistically significant differences. The value of the absolute difference was 0.17-0.29 D in spherical diopter and 0.04～0.07 D in cylindrical diopter. CONCLUSION In adult myopic patients, although the difference between spherical and cylindrical diopters was statistically significant using three different subjective refraction methods, the difference had no clinical significance in clinical practice. We conclude that, generally speaking, the accurate diopter can also be obtained by professional optometrists through strict manifest refraction after physical ciliary muscle relaxation in the phoropter.更多还原