基于矢量分解的验光法与常规主觉验光法应用于不同程度散光的比较研究
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摘要
目的比较矢量分解验光法和常规主觉验光法在不同程度散光下的应用。方法共纳入143名被检者的143只右眼,根据散光度数0~1.50 D和散光度数>1.50~3.00 D分为低散光组和高散光组,被检者先后接受两名视光医师的使用矢量分解验光法和常规主觉验光法获取验光数据,比较等效球镜M分量、J0分量、J45分量以及验光时长的差异。结果高、低散光组间的年龄、性别、M分量、J45分量和常规主觉验光耗时差异均没有统计学意义(均为P>0.05),两组间的常规主觉J0和矢量验光J0差异均有统计学意义(均为P=0.00)。低散光组中,分别使用常规主觉验光和矢量验光法所测得的M、J0和J45一致性较好,差值绝对值的平均值分别为0.04 D、0.02 D和0.02 D,一致性界限范围内,常规主觉验光和矢量验光的差值绝对值最大分别为0.37 D、0.13 D和0.17 D,且验光时长差异无统计学意义(P=0.72)。高散光组中,分别使用常规主觉验光和矢量验光法所测得的M、J0和J45一致性较差,差值绝对值的平均值分别为0.43 D、0.21 D和0.00 D,一致性界限范围内,常规主觉和矢量验光的差值绝对值最大分别为0.75 D、0.50 D和0.30 D,且验光时长差异有统计学意义(P=0.00),矢量验光法耗时较长。结论目前的矢量分解验光法只在针对较低的散光时有较好的表现,需要对其进一步完善,使其能较好地应用于临床。
Objective To compare subjective refraction based on power vectors and conventional subjective refraction in different degrees of astigmatism. Methods A total of 143subjects( 143 right eyes) were divided into two groups according to astigmatism degree:low astigmatism group( 0-1. 50 D) and high astigmatism group( 1. 50-3. 00 D). Subjects were then examined by both methods to fetch refraction data,and then the equivalent spherical M component,J0 component,J45 component and the duration of refraction procedures were compared and analyzed. Results There was no statistically difference in age,gender,M component,J45 component and time consuming of subjective refraction between the high and low astigmatism groups( all P > 0. 05),but intergroup comparison of J0 component from subjective refraction based on power vectors and conventional subjective refraction was significantly different( all P = 0. 00). In the low astigmatism group,the agreement of M,J0 and J45 measured by the two methods was unified,and the mean absolute value of M,J0 and J45 difference was 0. 04 D,0. 02 D and 0. 02 D,respectively;moreover,within the limits of consistency,the maximum absolute value of the difference was 0. 37 D,0. 13 D and 0. 17 D,respectively,and there was no statistically difference in time consuming of the two methods( P= 0. 72). In the high astigmatism group,the agreement of M,J0 and J45 measured by the two methods was poor,and the mean absolute value of M,J0 and J45 difference was 0. 43 D,0. 21 D and 0. 00 D,respectively; moreover,within the limits of consistency,the maximum absolute value of the difference was 0. 75 D,0. 50 D and 0. 30 D,respectively,and the difference in time consuming of the two methods approached statistical significance( P =0. 00),suggesting time consuming of subjective refraction based on power vectors was lon-ger. Conclusion Subjective refraction based on power vectors has good effect on low astigmatism,and it needs to be further improved for clinical practices.
Objective To compare subjective refraction based on power vectors and conventional subjective refraction in different degrees of astigmatism. Methods A total of 143subjects( 143 right eyes) were divided into two groups according to astigmatism degree:low astigmatism group( 0-1. 50 D) and high astigmatism group( 1. 50-3. 00 D). Subjects were then examined by both methods to fetch refraction data,and then the equivalent spherical M component,J0 component,J45 component and the duration of refraction procedures were compared and analyzed. Results There was no statistically difference in age,gender,M component,J45 component and time consuming of subjective refraction between the high and low astigmatism groups( all P > 0. 05),but intergroup comparison of J0 component from subjective refraction based on power vectors and conventional subjective refraction was significantly different( all P = 0. 00). In the low astigmatism group,the agreement of M,J0 and J45 measured by the two methods was unified,and the mean absolute value of M,J0 and J45 difference was 0. 04 D,0. 02 D and 0. 02 D,respectively;moreover,within the limits of consistency,the maximum absolute value of the difference was 0. 37 D,0. 13 D and 0. 17 D,respectively,and there was no statistically difference in time consuming of the two methods( P= 0. 72). In the high astigmatism group,the agreement of M,J0 and J45 measured by the two methods was poor,and the mean absolute value of M,J0 and J45 difference was 0. 43 D,0. 21 D and 0. 00 D,respectively; moreover,within the limits of consistency,the maximum absolute value of the difference was 0. 75 D,0. 50 D and 0. 30 D,respectively,and the difference in time consuming of the two methods approached statistical significance( P =0. 00),suggesting time consuming of subjective refraction based on power vectors was lon-ger. Conclusion Subjective refraction based on power vectors has good effect on low astigmatism,and it needs to be further improved for clinical practices.
引文
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[2]THIBOS LN,WHEELER W,HORNER D.Power vectors:an application of fourier analysis to the description and statistical analysis of refractive error[J].Optom Vis Sci,1997,74(6):367-375.
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[4]RAASCH T.Clinical refraction in three-dimensional dioptric space revisited[J].Optom Vis Sci,1997,74(6):376-380.
[5]SALMON TO,HORNER DG.A new subjective refraction method-The meridional polarized vernier optometer[J].Am Optom Assoc,1996,67(10):599-605.
[6]BARNES DA.Astigmatic decomposition:an alternative subjective refraction test employing conventional instrumentation[J].Ophthalmic Physiol Opt,2010,4(4):359-364.
[7]RAASCH TW.Optimizing subjective refraction[J].Invest Ophthalmol Vis Sci,2011,52(14):2822.
[8]REVERT A,CONVERSA MA,ALBARRAN DIEGO C,MICO V.An alternative clinical routine for subjective refraction based on power vectors with trial frames[J].Ophthalmic Physiol Opt,2017,37(1):24-32.
[9]MILLER JM.Clinical applications of power vectors[J].Optom Vis Sci,2009,86(6):599-602.
[10]NEMETH G,SZALAI E,BERTA A,MODIS L.Astigmatism prevalence and biometric analysis in normal population[J].Eur J Ophthalmol,2013,23(6):779-783.
[11]ATCHISON DA,SCHMID KL,EDWARDS KP,MULLER SM,ROBOTHAM J.The effect of under and over refractive correction on visual performance and spectacle lens acceptance[J].Ophthalmic Physiol Opt,2001,21(4):255-261.
[2]THIBOS LN,WHEELER W,HORNER D.Power vectors:an application of fourier analysis to the description and statistical analysis of refractive error[J].Optom Vis Sci,1997,74(6):367-375.
[3]HUMPHREY WE.Automatic retinoscopy:the Humphrey vision analyzer[J].Optician,1977,173(4479):17-27.
[4]RAASCH T.Clinical refraction in three-dimensional dioptric space revisited[J].Optom Vis Sci,1997,74(6):376-380.
[5]SALMON TO,HORNER DG.A new subjective refraction method-The meridional polarized vernier optometer[J].Am Optom Assoc,1996,67(10):599-605.
[6]BARNES DA.Astigmatic decomposition:an alternative subjective refraction test employing conventional instrumentation[J].Ophthalmic Physiol Opt,2010,4(4):359-364.
[7]RAASCH TW.Optimizing subjective refraction[J].Invest Ophthalmol Vis Sci,2011,52(14):2822.
[8]REVERT A,CONVERSA MA,ALBARRAN DIEGO C,MICO V.An alternative clinical routine for subjective refraction based on power vectors with trial frames[J].Ophthalmic Physiol Opt,2017,37(1):24-32.
[9]MILLER JM.Clinical applications of power vectors[J].Optom Vis Sci,2009,86(6):599-602.
[10]NEMETH G,SZALAI E,BERTA A,MODIS L.Astigmatism prevalence and biometric analysis in normal population[J].Eur J Ophthalmol,2013,23(6):779-783.
[11]ATCHISON DA,SCHMID KL,EDWARDS KP,MULLER SM,ROBOTHAM J.The effect of under and over refractive correction on visual performance and spectacle lens acceptance[J].Ophthalmic Physiol Opt,2001,21(4):255-261.