方法：共评估了90例患儿180眼的屈光状态。在散瞳或不散瞳状态下使用Plusoptix A09摄影验光仪检测屈光度，并与散瞳后使用普通自动验光仪测得的结果进行比较。使用Bland-Altman分析比较等效球镜、球镜度数、柱镜度数和柱镜轴J0、J45值。

结果：患者年龄3～13(7.48±3.01)岁。未散瞳状态下的Plusoptix A09摄影验光仪检测所得球镜度数和等效球镜与散瞳后的普通自动验光仪结果之间存在显著差异(P<0.001)，但是在柱镜度数、J0和J45值没有发现显著差异(P>0.05)。散瞳后Plusoptix A09摄影验光仪检测的球镜度数、等效球镜和散瞳后普通自动验光仪结果之间存在显著差异(P<0.001)，但是在柱镜度数、J0和J45值没有发现显著差异(P>0.05)。Bland-Altman相关性分析显示在球镜度数、柱镜度数和等效球镜的测量中未散瞳及散瞳的Plusoptix A09检测结果与散瞳后的普通自动验光仪检测结果有很好的一致性，但在J0和J45测量上一致性较差。

结论：为了检测儿童的屈光度，散瞳或不散瞳状态下Plusoptix A09可以得到可靠结果。但是在测量柱镜轴和高屈光度时，这项检测并不合适。这一设备是检测、筛查不合作儿童屈光度时的有效选择。

METHODS: We assessed the refractive status of 180 eyes in 90 pediatric patients. Refractions were measured with the Plusoptix A09 photorefractor(Plusoptix GmbH, Nürnberg, Germany)with and without cycloplegia and compared with those obtained by autorefractometer(Topcon KR-8900, Tokyo, Japan)after cycloplegia. Spherical equivalent, spherical power cylindrical power and cylindrical axis J0, J45 values measurements were analyzed with Bland-Altman analysis.

RESULTS: The mean age of the patients was 7.48±3.01(range 3 to 13y). Between the non-cycloplegic Plusoptix A09 photorefractometer and the cycloplegic autorefractometer measurements, there was significant difference between spherical power and spherical equivalent values(P<0.001)but there was no significant difference between cylindrical power, J0 and J45 values(P>0.05). Between the cycloplegic Plusoptix A09 photorefractometer and the cycloplegic autorefractometer measurements, there was significant difference between spherical power and spherical equivalent values(P<0.001)but there was no significant difference between the cylindric power, J0 and J45 values(P>0.05). Bland-Altman correlation analysis revealed an excellent correlation for the spherical power, cylindrical power and spherical equivalent measurements, but poor correlation for J0 and J45 values between the non-cycloplegic, cycloplegic Plusoptix A09 and the cycloplegic autorefractometer measurements.

CONCLUSION: To determine refractive errors in children, the Plusoptix A09 measurements with and without cycloplegia can give reliable results. But it is inadequate when measuring the cylindrical axis and high refractive values. This device can be an effective option to detect and screen refractive errors in uncooperative children.