The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China.
The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China.
Cont Lens Anterior Eye. 2021 Feb;44(1):81-88. doi: 10.1016/j.clae.2020.04.001. Epub 2020 Apr 30.
To investigate the effect of overnight orthokeratology (OOK) on the ocular surface and dry eye-related cytokines in children.
A non-randomized, prospective pilot study was conducted including sixty myopes treated with OOK and sixty age-matched spectacle wearing participants. The following tests were performed before and after 1, 3, 6 and 12 months: ocular surface disease index (OSDI), noninvasive tear breakup time (NITBUT), tear meniscus height (TMH), corneal fluorescein staining (CFS), meiboscore using noncontact meibography. Then the concentrations of interleukin-17A (IL-17A), interleukin-6 (IL-6), and prostaglandin E2 (PGE2) in tear samples were detected with a multiplex immunobead assay at different time points.
All parameters had no statistical differences between the two groups prior to treatment. No adverse events were observed except trace to moderate corneal staining and allergic conjunctivitis in the treatment group. NITBUT significantly decreased after 6 and 12 months OOK wearing (P = 0.003 and P = 0.001, respectively). After wearing OOK there was a significant increase in CFS at each follow-up time point compared with baseline (P = 0.023, P = 0.016, P = 0.001, and P < 0.001at 1, 3, 6, and 12 months, respectively). The upper meiboscore and the total meiboscore increased gradually and peaked at 12 months of OOK (both P < 0.001). The concentration of the three cytokines in the treatment group significantly increased after OOK wearing. These increases occurred at different time points: IL-17A increased significantly 3 months after OOK, IL-6 at 6 months, and PGE2 at 12 months (all P < 0.001). However, there were no significant changes in the above parameters in the control group. There were no significant differences in the OSDI or TMH at any follow-up time point compared to baseline in both groups (both P > 0.05).
Short-term OOK may reduce the stability of the tear film and increase damage to the corneal epithelium. Long-term OOK could induce ocular inflammation through the disruption of meibomian glands.
探讨过夜角膜塑形术（OK）对儿童眼表和干眼相关细胞因子的影响。
本研究为非随机、前瞻性初步研究，纳入 60 名接受 OK 治疗的近视儿童和 60 名年龄匹配的戴镜参与者。在治疗前和治疗后 1、3、6 和 12 个月时进行以下检查：眼表疾病指数（OSDI）、非侵入性泪膜破裂时间（NITBUT）、泪膜高度（TMH）、角膜荧光素染色（CFS）、非接触式睑板腺照相术的睑板腺评分。使用多重免疫珠测定法在不同时间点检测泪液样本中白细胞介素 17A（IL-17A）、白细胞介素 6（IL-6）和前列腺素 E2（PGE2）的浓度。
治疗前两组各项参数均无统计学差异。除治疗组有微量至中度角膜染色和过敏性结膜炎外，未观察到其他不良反应。NITBUT 在 6 个月和 12 个月 OK 佩戴后显著降低（P=0.003 和 P=0.001）。OK 佩戴后，与基线相比，各随访时间点的 CFS 均显著增加（P=0.023、P=0.016、P=0.001 和 P<0.001，分别在 1、3、6 和 12 个月时）。上睑板腺评分和总睑板腺评分逐渐升高，并在 OK 佩戴 12 个月时达到高峰（均 P<0.001）。治疗组三种细胞因子的浓度在 OK 佩戴后显著增加。这些增加发生在不同的时间点：OK 佩戴 3 个月后 IL-17A 显著增加，6 个月后 IL-6 增加，12 个月后 PGE2 增加（均 P<0.001）。然而，对照组在任何随访时间点上述参数均无显著变化。两组在任何随访时间点的 OSDI 或 TMH 与基线相比均无显著差异（均 P>0.05）。
短期 OK 可能会降低泪膜稳定性并增加角膜上皮损伤。长期 OK 通过破坏睑板腺可引起眼内炎症。
