中华眼科杂志 2000年第1期第36卷 论著

作者：李军　汪芳润　吉红云

单位：李军（上海医科大学附属金山医院眼科　200540）；汪芳润（上海医科大学附属金山医院眼科　200540）；吉红云（上海医科大学附属金山医院眼科　200540）

关键词：屈光不正；玻璃体；角膜屈光力

　　【摘要】　目的　探讨原发性屈光不正的性质，明确眼球各屈光成分，特别是玻璃体腔径对原发性屈光不正的作用。方法　检测1 336只眼的屈光状态、角膜屈光力（corneal refractive power, CP）、眼前节长度（anterior ocular segment length, ASL）、玻璃体腔径(vitreous cavity length, VL)及视轴长度(ocular axial length, AL)，其中远视523只眼，正视199只眼，近视614只眼。分组研究CP的分布规律及各组间的差别、ASL和VL与屈光状态的关系、AL和VL同步变化的规律。结果　远视眼、正视眼和近视眼CP的分布规律经检验均呈正态分布；远视眼与正视眼、正视眼与近视眼比较，CP的均数差异均无显著性(P＞0.05)；ASL不随屈光度的变化表现规律性变化；VL随屈光度的改变进行性变化，各组间差异有显著性（F=204.29，P＜0.01）；AL与VL同步变化，两者的变化量之间经比较差异无显著性(P＞0.05)；AL与VL显著相关，相关系数为0.879。结论　眼球前节（包括CP和ASL）结构对屈光状态无明显作用；VL决定AL，从而决定屈光状态；VL是决定原发性屈光不正最主要的解剖因素。

A study on the effect of vitreous cavity length in primary ametropia

LI Jun, WANG Fangrun, JI Hongyun.

　　（Department of Ophthalmology, Jin Shan Hospital, Shanghai Medical University, Shanghai 200540，China）

　　【Abstract】　Objective　To study the nature of primary ametropia and disclose the actions of ocular refractive components, especially the length of vitreous cavity, on primary ametropia. Methods　 The refractive state, corneal refractive power (CP), anterior ocular segment length (ASL), vitreous length (VL) and ocular axial length (AL) were measured for 1 336 eyes, including 523 hyperopic eyes, 199 emmetropic eyes and 614 myopic eyes. The relationships of these elements were studied. Results　CP had no effect on the refractive state. There was no significant difference between CP of these three refractive groups (hyperopia vs. emmetropia and emmetropia vs. myopia)(P＞0.05). The test of normality showed that the distribution of CP was normal in each refractive state. Case control study of paired sample revealed that ASL did not change regularly with the change of refraction, while VL changed progressively with the change of refraction and there was significant difference between each pair of groups(F=204.29, P＜0.01). The study of the relationship with matching t test between AL and VL showed that the change amount of AL and VL was nearly the same, that was, the growth of AL was about the same as the growth of VL(P＞0.05). Analysis of correlation and regression showed that these two elements were highly correlated, the coefficient of correlation being 0.879. Conclusion　 VL determines AL and finally determines refractive state. VL is the most important element in determining primary ametropia while the anterior eye segment has no significant contribution.

　　【Key words】　Refractive errors; Vitreous body; Corneal power

　　对于原发性屈光不正的性质，曾有轴性及屈折性两种学说^［1-3］。前者虽已被人们逐渐接受，但仍缺少确切论据。近年来随着活体眼球径测量新技术的应用^［4,5］，使得人们对轴性学说有了新的认识。为了计算各屈光成分具体的比例数据，以明确各屈光成分在屈光过程中所占的真正地位及相互关系，本研究旨在以往工作的基础上，做些尝试，着重探讨玻璃体腔径在决定屈光状态中的作用，从而为进一步认识原发性屈光不正的性质，探讨近视眼形成的机制及治疗方法等提供依据。

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