目的：研究7-18岁近视的中小学生双眼散光程度、轴向分布及轴向对称模式。

方法：随机选取2020-2022年于郑州大学第五附属医院验配角膜塑形镜矫正近视的7-18岁中小学生239例478眼，在睫状肌麻痹状态下验光，进行统计分析。

结果：散光程度：0.25-1.00 D占78.5%，1.25-2.00 D占17.1%，>2.00 D占4.4%。散光轴向分布：顺规散光占86.6%，逆规散光占5.9%，斜轴散光占7.5%。性别、不同散光程度均以顺规散光为主，与其他两种轴向分布存在差异(均P<0.05)。散光的轴向对称模式：直接对称模型和镜像对称模型的散光轴向差异中位数分别是7°和10°，两者比较无差异(P=0.158)，在性别、散光程度、散光轴向分布中两者均无差异，但在7-12岁组中，直接对称模型和镜像对称模型的散光轴向差异有统计学意义(P=0.027)。

结论：近视的中小学生双眼散光轴向分布大多为顺规散光，散光程度以0.25-1.00 D多见，散光轴向对称模式并无倾向。

METHODS:A total of 239 cases(478 eyes)of primary and secondary school students aged 7-18 years who underwent keratoplasty for myopia correction at the Fifth Affiliated Hospital of Zhengzhou University from 2020 to 2022 were randomly selected, and optometry was performed under ciliary muscle paralysis and was statistically analyzed.

RESULTS:Astigmatism degree: 0.25 to 1.00 D accounted for 78.5%, 1.25 to 2.00 D accounted for 17.1%, and >2.00 D accounted for 4.4%. The axial distribution of astigmatism: 86.6% was astigmatism with the rule, 5.9% was astigmatism against the rule, and 7.5% was oblique astigmatism; both genders and different astigmatism degrees were dominated by astigmatism with the rule, and there were differences with the other two axes(both P<0.05). Axial symmetry pattern of astigmatism: the median axial difference in astigmatism between the direct symmetry model and the mirror symmetry model was 7° and 10°, respectively, with no statistical significance in both models(P=0.158), and there was no difference between the two in gender, degree of astigmatism, and axial distribution of astigmatism, but in the age group of 7-12 years old, the difference between the axial astigmatism of the direct symmetry model and the mirror symmetry model was statistically significant(P=0.027).

CONCLUSION:The axial distribution of binocular astigmatism in myopic primary and middle school students is mostly astigmatism with the rule; the degree of astigmatism is more common from 0.25 to 1.0 D; however, there is no tendency for axial symmetry pattern of astigmatism.