【摘要】 目的：了解三种不同方法手指法、卡洞法、Worth四点仪法检查主导眼的优缺点，为临床应用提供参考。方法：选择来我院近视眼中心拟行LASIK手术的近视眼患者118例（236眼），年龄18～42（平均25.3±6.2）岁，LASIK手术前用三种不同方法手指法、卡洞法、Worth四点仪法检查主导眼并记录每位患者主导眼的眼别。结果：经统计学一致性检验表明，手指法与卡洞法检查主导眼时两种方法一致性好，符合率高；Worth四点仪法与手指法和卡洞法两两比较一致性差，符合率也较低。结论：本研究结果提示，手指法、卡洞法、Worth四点仪法检查主导眼各有优缺点，因手指法与卡洞法两种方法一致性好、符合率高，检查简便易行可以联合起来作为临床上确定主导眼的检查方法；Worth四点仪法因本身作为融像的检查方法且受影响的因素较多，不适合作为主导眼的检查方法。
【关键词】 主导眼；手指法；卡洞法；Worth四点仪法
Clinical observation of three ways of checking ocular dominance
KeJia Li, HanQiang Liu
Department of Ophthalmology, Yanhua Hospital of Beijing, Beijing 102500, China;Department of Ophthalmology, the First Affiliated Clinical Hospital, China Medical University, Shenyang 110001, Liaoning Province, China
Abstract
AIM: To study the advantages and disadvantages of the three ways of checking ocular dominance and to find which one is better.
METHODS: We checked 118 patients (236 eyes) who were going to accept LASIK operation. The ages of those patients were arranged from 18 to 42 years. Everyone were checked ocular dominance with three ways of finger method, cardhole method and Worth fourspot meter method before operation. The results were recorded.
RESULTS: The results showed that finger method and cardhole method had better consistency and coincidence than Worth fourspot meter method.
CONCLUSION: Finger method, cardhole method and Worth fourspot meter method have respective advantages and disadvantages. Finger method and cardhole method can be the conventional ways of checking ocular dominance clinically becouse of they have better consistency and coincidence, while Worth fourspot meter method is not a good way because it is affected by a lot of agents.
KEYWORDS: ocular dominance; finger method; cardhole method; Worth fourspot meter method
0引言
主导眼的确定在验光配镜、斜弱视和LASIK手术中都有广泛应用，因此寻找简便易行而判断准确的确定主导眼的检查方法尤为重要，为此我们对临床上常用的手指法、卡洞法和Worth四点仪法确定主导眼的情况进行对比观察，现报告如下。
1对象和方法
1.1对象 随机选择200508/200510来我院近视眼中心就诊的LASIK手术的近视眼患者118例（236眼），年龄18～42（平均25.3±6.2）岁，其中男44例（37.3%）；女74例（62.7%）。双眼中右眼等效球镜：1.00～12.75D，平均屈光度：（5.42±2.37）D；左眼等效球镜：0.5 ～ 13.00D，平均屈光度：（5.33±2.27）D。双眼矫正视力均≥0.8，且两眼视力差别<2行。均无斜弱视等其它眼病、全身疾病以及手术外伤史。卡洞法：使用美国医拓有限公司生产的主导眼测试卡（一张20cm×13cm中间带有直径3cm圆洞的卡片）；Worth四点仪：使用NIDEK RT600型综合验光仪上的Worth四点视标。
1.2方法 手指法：嘱患者选5m远处的一个竖线为目标，双眼注视该竖线，伸出右手食指，使手指遮挡竖线，这时任意闭上一只眼睛，当某只眼睛睁开时手指没有偏离竖线时该只眼即为主导眼；卡洞法：患者端坐平视选5m远处一物体作为聚焦点，双眼同时注视该物体，双手平举卡片使双眼能同时从洞中将视线集中在聚焦点上，手持卡片慢慢往眼前移动并始终保持双眼能从卡洞中注视到聚焦点上，当卡片触及脸部时卡洞所对之眼即为主导眼；Worth四点仪法：患者端坐在综合验光仪前，每位患者的屈光不正都在综合验光仪上得到充分矫正，将Worth四点视标投射在投影仪上，患者通过综合验光仪看Worth四点视标，下方白色视标如显示偏红色说明右眼为主导眼，显示偏绿色说明左眼为主导眼。
统计学分析：用SPSS 11.5软件对三种检查主导眼的方法两两之间行一致性检验。
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