摘要目的:评估视频终端防护镜(蓝、紫光滤过镜)缓解长期操作视频终端引起的视疲劳的效果.方法:前瞻性临床研究.将在浙江省人民医院超声科工作的60例(26～45岁)符合视疲劳诊断的长期视频终端操作者随机分为2组,实验组30例和对照组30例.实验开始时,2组受试者常规医学验光后配戴普通非球面眼镜,在视频前工作lh后开始测量双眼视功能和泪膜破裂时间(BUT),最后进行视疲劳问卷评分.随即实验组配戴视频终端防护镜,对照组配戴普通非球面眼镜进行对比敏感度(CS)测量.2组配戴各自的眼镜3个月后,在视频前工作lh后做双眼视功能和BUT检测,并再次进行视疲劳问卷评分.数据采用独立样本t检验、配对t检验、卡方检验进行比较.结果:实验开始时,实验组明环境带眩光中低频率光栅CS(1.0 cpd、1.7 cpd、2.6 cpd)显著高于对照组(t=2.181、2.012、2.088,P＜ 0.05),暗环境下低频率光栅CS(1.0 cpd、1.7 cpd)显著高于对照组(t=2.220、2.558,P＜0.05).无眩光时,实验组在明、暗环境下低频率光栅CS(1.0 cpd、1.7 cpd)高于对照组(明:t=2.123、2.530,P＜ 0.05;暗:t=2.433、2.140,P＜0.05).实验组配戴视频终端防护镜3个月后,调节幅度(AMP)、调节灵敏度和BUT值显著增高(t=-2.735、-3.281、-2.249,P＜0.05),集合破裂点(NPC)显著移近,近距外隐斜值减少,视疲劳评分显著降低(t=3.049、1.369、3.754,P＜0.05).对照组配戴普通非球面眼镜片3个月后,AMP、NPC、调节灵敏度、远/近距隐斜量和BUT值变化均不明显,视疲劳评分并无显著降低.实验组和对照组实验前后调节性集合/调节值差异均无统计学意义.戴镜3个月,2组受试者不良反应构成比差异均无统计学意义.结论:通过3个月的观察,视频终端防护镜(蓝、紫光滤终端过镜)较普通框架眼镜能提高低、中频率CS,改善配戴者双眼视功能,提高BUT,缓解长期操作视频引起的视疲劳,配戴过程中未出现严重不良反应.

abstractsObjective:To evaluate the effects of video terminal protective lenses in relieving asthenopia of video operators.Methods:This prospective clinical research included 60 video operators (age range:26-45 years) with asthenopia symptoms while working in the ultrasound department of our hospital.The subjects were randomly assigned to two groups.The test group (n=30) wore video terminal protective lenses.The control group (n=30) wore ordinary aspherical lenses.After one hour of video operation,binocular vision-related testing and tear break up time (BUT) were measured in all subjects wearing the ordinary aspherical lenses,and an asthenopia questionnaire assessment was administered.After that,subjects in each group underwent contrast sensitivity (CS),and then they worked as usual,wearing their assigned lenses.Three months later,the subjects in each group underwent binocular vision-related testing,and BUT measurements.The asthenopia questionnaire assessment was again administered as well as the adverse reaction questionnaire.Data were analyzed by t-tests and chi-square tests.Results:After wearing video terminal protective lenses,the CS with glare at low and medium-frequency grating (1.0 cpd,1.7 cpd,2.6 cpd) in the test group were significantly higher than in the control group under bright conditions (t=2.181,2.012,2.088,all P＜0.05).Under dark conditions,the CS of various frequencies in the test group also higher than in the control group (t=2.220,2.558,both P＜0.05) at low-frequency grating (1.0 cpd、1.7 cpd).The CS at low-frequency grating in the absence of glare in the test group was higher than in the control group (bright:t=2.123,2.530,both P＜0.05;dark:t=2.433,2.140,both P＜0.05).In the test group,after wearing the video terminal protective lenses for three months,the amplitude of accommodation,accommodative sensitivity,and BUT were significantly elevated (t=-2.735,-3.281,-2.249,all P＜0.05),while the near point of convergence,near lateral exophoria,and the asthenopia gratings were significantly decreased (t=3.049,1.369,3.754,all P＜0.05).However,in the control group,the amplitude of accommodation,near point of convergence,accommodative sensitivity,phorias,and BUT after 3 months were not significantly altered compared with those before the experiment.Further,the asthenopia grating was not significantly decreased.Accommodative converse/Accommodation ratio in neither group was significantly altered compared with before the experiment.At 3 months,the constituent ratio of adverse reactions was not significantly different between the two groups.Conclusions:A 3-month follow-up revealed that compared with ordinary glasses,video terminal protective lenses increased the low-and medium-frequency CS under bright and dark conditions and improved binocular visual function and BUT.The improvements effectively relieved asthenopia and had no severe adverse reactions,suggesting the potential for clinical application.