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长期佩戴软性隐形眼镜对近视患者角膜厚度和角膜上皮厚度的影响。

Effects of long-term soft contact lens wear on the corneal thickness and corneal epithelial thickness of myopic subjects.

作者信息

Lei Yulin, Zheng Xiuyun, Hou Jie, Xu Baozeng, Mu Guoying

机构信息

School of Medicine, Shandong University, Jinan, Shandong 250012, P.R. China.

Department of Ophthalmology, Jinan Mingshui Eye Hospital, Zhangqiu, Shandong 250200, P.R. China.

出版信息

Mol Med Rep. 2015 Mar;11(3):2020-6. doi: 10.3892/mmr.2014.2964. Epub 2014 Nov 17.

Abstract

To perform safe and successful corneal refractive surgery on myopic patients, corneal thickness (CT) and corneal epithelial thickness (CET) must be accurately measured. Numerous individuals with myopia wear soft contact lenses (SCLs) for the correction of visual acuity but may subsequently undergo corneal refractive surgery. The aim of the present study was therefore to investigate the effects of long-term SCL wear on the CT and the CET of myopic subjects in order to guarantee the safety and accuracy of subsequent corneal refractive surgeries. Fifty-six subjects prepared to receive refractive surgery at Jinan Mingshui Eye Hospital (Zhangqiu, China) from April to July 2013 were included in the study. CT and CET were measured in subjects immediately following discontinued SCL wear (group I, 56 eyes), and subsequently following >two weeks of discontinued SCL wear (group II, 56 eyes). Ninety-four subjects with no history of corneal contact lens wear were enrolled as a control group. The CT and CET were measured at positions with a radius of 0.0‑1.0, 1.0-2.5 (divided into eight quadrants) and 2.5-3.0 mm (divided into eight quadrants) away from the corneal center using the RTVue-100 Fourier-domain anterior segment optical coherence tomography system. A significant decrease in the CT of the subjects in group II was observed, compared with that of group I and the control group (P<0.05). A significant decrease was observed in the CET of groups I and II compared with that of the control group (P<0.05). Following discontinuation of SCL wear, CET increased. However, the increased CET was unable to reach the normal range exhibited by the control group. Edema and thinning of the corneal stroma, as well as thinning of the corneal epithelium were observed in groups I and II. In conclusion, it was proposed that in clinical practice, for myopic patients following long-term SCL wear, CT and CET should be determined ≥ two weeks following discontinuation of SCL wear, once a stable CT and CET are obtained.

摘要

为了对近视患者进行安全且成功的角膜屈光手术,必须准确测量角膜厚度(CT)和角膜上皮厚度(CET)。许多近视患者佩戴软性隐形眼镜(SCL)来矫正视力,但随后可能会接受角膜屈光手术。因此,本研究的目的是调查长期佩戴SCL对近视患者CT和CET的影响,以确保后续角膜屈光手术的安全性和准确性。2013年4月至7月在济南明水眼科医院(中国章丘)准备接受屈光手术的56名受试者纳入本研究。在受试者停止佩戴SCL后立即测量CT和CET(I组,56只眼),随后在停止佩戴SCL超过两周后测量(II组,56只眼)。94名无角膜接触镜佩戴史的受试者作为对照组。使用RTVue-100傅里叶域眼前节光学相干断层扫描系统在距角膜中心半径为0.0 - 1.0、1.0 - 2.5(分为八个象限)和2.5 - 3.0 mm(分为八个象限)的位置测量CT和CET。与I组和对照组相比,观察到II组受试者的CT显著降低(P<0.05)。与对照组相比,I组和II组的CET显著降低(P<0.05)。停止佩戴SCL后,CET增加。然而,增加的CET未能达到对照组所呈现的正常范围。在I组和II组中观察到角膜基质水肿和变薄以及角膜上皮变薄。总之,建议在临床实践中,对于长期佩戴SCL的近视患者,应在停止佩戴SCL两周后,一旦获得稳定的CT和CET,再确定CT和CET。

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