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夜间佩戴角膜塑形镜对角膜形态和泪液的影响。

Effect of Overnight Wear Orthokeratology Lenses on Corneal Shape and Tears.

作者信息

Li Jian, Dong Ping, Liu Hu

机构信息

Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Eye Contact Lens. 2018 Sep;44(5):304-307. doi: 10.1097/ICL.0000000000000357.

Abstract

OBJECTIVE

The aim of this study was to explore the effects of the overnight wear orthokeratology (OK) lenses on corneal shape and tear film stability.

METHODS

Forty patients with myopia aged between 11 and 18 years who wore OK lens continuously for more than 1 year were selected. Refractive error (D), corneal curvature, corneal surface regularity index (SRI), tear breakup time (TBUT), Schirmer I test score, and corneal staining were measured at the following time points: 1 week before wearing the OK lens (T0) and 1 week (T1), 1 month (T2), 3 months (T3), 6 months (T4), and 12 months (T5) after wear.

RESULTS

Compared with T0, the average spherical refractions at other time points had become less myopic, flattens the central cornea, the SRI increased, and the TBUT decreased (P<0.01). All the aforementioned variables became stable at T1. Conversely, results of the Schirmer I test showed no significant changes. The number of patients with a corneal epithelium stained with fluorescein increased; staining was mainly of the grade I type. At each time point, the TBUT in patients with grade I corneal fluorescein staining was significantly lower than in patients with grade 0 staining (P<0.05).

CONCLUSIONS

The overnight wear OK lenses may have decreased the degree of myopia and flattened the cornea while leaving basal tear secretion unaffected; however, the stability of tears decreased, therefore regular follow-ups are recommended.

摘要

目的

本研究旨在探讨夜戴角膜塑形镜(OK镜)对角膜形态和泪膜稳定性的影响。

方法

选取40例年龄在11至18岁之间、连续佩戴OK镜超过1年的近视患者。在佩戴OK镜前1周(T0)以及佩戴后1周(T1)、1个月(T2)、3个月(T3)、6个月(T4)和12个月(T5)时测量屈光不正(D)、角膜曲率、角膜表面规则性指数(SRI)、泪膜破裂时间(TBUT)、泪液分泌试验Ⅰ(Schirmer I)评分以及角膜染色情况。

结果

与T0相比,其他时间点的平均球镜度数近视程度减轻,中央角膜变平,SRI增加,TBUT降低(P<0.01)。上述所有变量在T1时趋于稳定。相反,泪液分泌试验Ⅰ的结果显示无显著变化。角膜上皮荧光素染色的患者数量增加;染色主要为Ⅰ级。在每个时间点,Ⅰ级角膜荧光素染色患者的TBUT显著低于0级染色患者(P<0.05)。

结论

夜戴OK镜可能降低了近视度数并使角膜变平,同时不影响基础泪液分泌;然而,泪膜稳定性下降,因此建议定期随访。

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