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1%Cyclogyl和Mydrin-P睫狀肌麻痺之比較

Comparative Study of Cycloplegic Refraction with 1% Cyclogyl and Mydrin-P

摘要


調焦性內斜視是內斜視的主要原因之一,此症發生於幼兒遠視眼之病例。治療調焦性內斜視的方法在於全量矯正其遠視眼以減少調焦作用,從而減少輻輳運動及內斜視,故必需使用睫狀肌麻痺劑得到其遠視眼的全量,才能加以完全矯正。本文對年紀輕的兒童20人,共40眼,由1.4歲到7.0歲,平均年齡4.3歲,不限定其是否有斜視、近視、遠視,先每10分鐘點眼一次Mydrin-P一滴,計點三次,最後一次點眼後30分鐘進行電腦驗光。至少間隔三天後再每10分鐘點眼一次1%Cyclogyl一滴,計點三次,最後一次點眼後60分鐘進行電腦驗光,比較兩者的睫狀肌麻痺作用。全部40眼用配對T檢定統計,1%Cyclogyl較Mydrin-P睫狀肌麻痺量平均多0.30D;選擇球鏡當量大於或等於+0.5D的遠視眼之26眼統計,1%Cyclogyl較Mydrn-P平均多0.30D,二者均具有統計上的差異。以1%Cyclogyl點眼大部分小孩有疼痛感及結膜充血,二位有皮膚過敏,一位有癲癇病史的小孩有癲癇發作。臨床屈光檢查診斷上,1%Cycfogyl適用於篩選檢查;在內斜視合併遠視眼的病人,特別是幼兒病人處在調焦性內斜視常發生的年齡群,1%Cyclogyl是值得使用的藥物,但須小心其副作用。並建議在進一步約診時,以atropine求得病人睫狀肌完全麻痺下的屈光狀態。

關鍵字

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並列摘要


Accommodative esotropia is one of the most common causes of esodeviation in children with hypermetropia and an accurate cycloplegic refraction is essential to all children patients with strabismus. We evaluated the effectiveness of two cycloplegics, 1% Cyclogyl (1% cyclopentolate) and Mydrin-p (0.5% tropicamide +0.5% phenylephrine) in 40 eyes of 20 young children. Age was between 1.4 and 7.0 years old, average 4.3 years old. The cycloplegic refraction was done with 3 drops of Mydrin-p with a ten-minute interval. The refractive status was determined by a autorefractometer after 30 minutes. At least 3 days later, the cycloplegic refraction was repeated with 1% Cyclogyl to the same subject. The refractive status was determined 60 minutes later. The postcycloplegic refraction of all 40 eyes showed that 1% Cyclogyl produced +0.30D more plus than Mydrin-p with statistical significance (paired-t-test). In 26 hyperopic eyes, 1% Cyclogyl also showed +0.30D more plus than Mydrin-p. Most of patients felt transient stinging and conjunctival hyperemia after instillation of 1% Cyclogyl drops. Two children developed skin hypersensitive reaction and another one child with epilapsy history got a seizure attack. The result showed that 1% Cyclogyl is more effective than Mydrin-p in the cycloplegic refraction of children. However, practitioners should be aware of the topical and systemic side effects of cyclopentolate.

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