目的: 探讨湖北地区0~6岁早产儿屈光度的正常参考值范围,为学龄前早产儿屈光异常的临床诊治提供依据。方法: 系列病例研究。在2016年5月至2017年5月期间,回访既往于武汉大学人民医院眼科行视网膜筛查的0~6岁无早产儿视网膜病变（ROP）的早产儿1 505例,行睫状肌麻痹后进行屈光检查。按照矫正胎龄后的年龄进行分组,了解各年龄组双眼球镜度及柱镜度的P₅₀参考值和75%参考值范围。采用两独立样本秩和检验比较不同出生体质量、不同胎龄早产儿的屈光度差异。结果: ①0~6岁早产儿球镜度的参考值分别为：<0.5岁组+2.02 D,≥0.5岁且<1.0岁组+1.87 D,≥1.0岁且<2.0岁组+1.60 D等。②各年龄段柱镜度的绝对值分别为：<0.5岁组2.54 D、≥0.5岁且<1.0岁组2.29 D、≥1.0岁且<2.0岁组2.14 D。③随着年龄增长,各年龄段早产儿球镜度P₅₀参考值呈现逐渐下降的趋势（ P<0.05）,5~6岁早产儿基本完成正视化过程;0~3岁早产儿柱镜度P₅₀参考值随着年龄增长呈现逐渐下降的趋势（ P<0.05）,3岁以上趋于稳定。④<0.5岁组及1~6岁各年龄组,出生体质量<1.5 kg比出生体质量≥1.5 kg的早产儿球镜度小（ P<0.05）;出生体质量<1.5 kg早产儿在出生后早期远视度增加（ P<0.05）,后逐步向正视化方向发展,4~5岁基本完成正视化。⑤0~0.5岁及2~6岁年龄段,胎龄<32周比胎龄≥32周的早产儿球镜度小（ P<0.05）。0~6岁各年龄段,胎龄<32周比胎龄≥32周的早产儿柱镜度高（ P<0.05）;0~6岁各年龄段,出生体质量<1.5 kg比出生体质量≥1.5 kg的早产儿柱镜度高（ P<0.05）。结论: 随着年龄增长,早产儿远视度逐渐减小,5~6岁早产儿基本完成正视化过程;0~3岁早产儿柱镜度随年龄增长呈现逐渐缩小的趋势,3岁以上柱镜度数趋于稳定。出生体质量及胎龄是早产儿屈光度的重要影响因素。

Objective: In a cohort of prematurely born children in the province of Hubei, China, we investigated the dioptric range in 0 - 6 year-old with premature ametropia to provide the basis for clinical diagnosis and therapy.Methods: Follow-up visits were conducted in 1 505 premature infants without retinopathy of prematurity in Renmin Hospital of Wuhan University from May 2016 to May 2017 in this case serial study. Refraction was measured by cycloplegic retinoscopy. According to the correct gestational age groups, the P₅₀ reference and 75% reference ranges of the spherical diopters and cylindrical lens diopters were obtained respectively. The spherical and cylindrical lens diopters of children at the current ages of 0-0.5, 0.5-1, 1-2, 2-3, 3-4, 4-5, and 5-6 years and with birth weights <1.5 kg and ≥1.5 kg were compared by the rank-sum tests.Results: The age-related spherical diopter (D) reference values were as follows: 0-0.5 year, +2.02 D; 0.5-1 year, +1.87 D; 1-2 years, +1.60 D. The corresponding absolute reference values of the cylindrical lens were as follows: 2.54 D, 2.29 D, 2.14 D. With increasing age, the spherical diopter diminished ( P<0.05), and in 5-6 year-old preterm infants, the process of becoming emmetropic was essentially completed. With increasing age, the cylindrical diopter decreased from age 0 to 3 years ( P<0.05). After 3 years, it began to stabilize. For 0-0.5 year old and 1-6 years old age group, premature infants with birth weights <1.5 kg, the spherical diopter was smaller than for those with birth weights ≥1.5 kg ( P<0.05), and they had early hyperopia that increased after birth ( P<0.05). The hyperopia then gradually diminished, and the eyes were emmetropic by 4-5 years. For premature infants whose gestational age < 32 weeks, the spherical diopter was smaller than for those with gestational age ≥32 weeks. For premature infants whose birth weight <1.5 kg, the cylinder diopter was higher than for those with birth weight ≥1.5 kg ( P<0.05), whose gestational age < 32 weeks, the cylindrical diopter was higher than for those with gestational age ≥32 weeks ( P<0.05).Conclusions: With increasing age, the hyperopia of premature infants gradually decreased. Preterm infants between 5 and 6 years old had essentially completed the emmetropization process. Astigmatism in preterm infants at 0-3 years gradually decreased with age and tended to be stable at age 3 years. Birth weight and gestational age are important influencing factors for the vision of premature infants.