Yang Yuanfang, Wu Qinghui, Tang Yao, Wu Haoran, Luo Zhiwei, Gao Wenyu, Hu Ziqi, Hou Lijun, Wang Min, Yang Zhikuan, Li Xiaoning
Aier School of Ophthalmology, Central South University, Changsha, China.
Aier Institute of Optometry and Vision Science, Changsha, China.
Front Med (Lausanne). 2023 Jul 13;10:1130117. doi: 10.3389/fmed.2023.1130117. eCollection 2023.
This aim of this study was to evaluate the effect of 3% Diquafosol Ophthalmic Solution (DQS) on children with dry eye from wearing overnight orthokeratology (OrthoK) lenses.
Myopic children aged 8-18 years with dry eye syndrome were enrolled in this prospective observational study, and they were grouped according to their OrthoK treatment history for at least 1 year. All participants received DQS 4 times per day for 1 month. The following indicators were measured at baseline 1 month after treatment: the Dry Eye Questionnaire-5 (DEQ-5), non-invasive tear meniscus height (TMH), non-invasive tear film break-up time (first and average, NIBUT-F and NIBUT-A), meibomian gland score (MG score), conjunctival hyperemia redness score (R-scan), and blink pattern analysis.
A total of 104 participants (189 eyes) including 40 OrthoK wearers (72 eyes) and 64 Orthok candidates (117 eyes) completed the study. Of all, after DQS treatment for 1 month, DEQ-5 scores reduced from 5.54 ± 3.25 to 3.85 ± 2.98 ( = -3.36, = 0.00). TMH increased from 0.20 ± 0.05 mm to 0.21 ± 0.05 mm ( = 2.59, = 0.01), NIBUT-F and NIBUT-A were prolonged from 6.67 ± 4.71 s to 10.32 ± 6.19 s and from 8.86 ± 5.25 s to 13.30 ± 6.03 s (all = 0.00), respectively. R-scan decreased from 0.69 ± 0.28 to 0.50 ± 0.25 ( = -9.01, = 0.00). Upper MG scores decreased from 1.04 ± 0.32 to 0.97 ± 0.36 ( = -2.14, = 0.03). Lower MG scores, partial blink rate, partial blinks, and total blinks did not change significantly. Both break-up time (BUT) and R-scan improved significantly after DQS treatment for 1 month (all = 0.00) in OrthoK candidates and OrthoK wearers. Among the OrthoK wearers, TMH and dry eye symptoms increased significantly (all = 0.00) but did not increase in OrthoK candidates ( > 0.05). There were no adverse events related to DQS.
Diquafosol Ophthalmic Solution was effective for children wearing overnight orthokeratology in relieving dry eye symptoms and improving ocular surface parameters, which may help improve children's OrthoK wearing tolerance and compliance.
本研究旨在评估3%双醋瑞因眼用溶液(DQS)对因佩戴过夜角膜塑形镜(OrthoK)而患干眼症的儿童的疗效。
本前瞻性观察性研究纳入了8-18岁患有干眼综合征的近视儿童,并根据其至少1年的OrthoK治疗史进行分组。所有参与者每天使用DQS 4次,持续1个月。在治疗前基线及治疗1个月后测量以下指标:干眼问卷-5(DEQ-5)、非侵入性泪河高度(TMH)、非侵入性泪膜破裂时间(首次和平均,NIBUT-F和NIBUT-A)、睑板腺评分(MG评分)、结膜充血发红评分(R-scan)和眨眼模式分析。
共有104名参与者(189只眼)完成了研究,其中包括40名OrthoK佩戴者(72只眼)和64名OrthoK候选者(117只眼)。总体而言,DQS治疗1个月后,DEQ-5评分从5.54±3.25降至3.85±2.98(t=-3.36,P=0.00)。TMH从0.20±0.05mm增加到0.21±0.05mm(t=2.59,P=0.01),NIBUT-F和NIBUT-A分别从6.67±4.71秒延长至10.32±6.19秒和从8.86±5.25秒延长至13.30±6.03秒(均为t=0.00)。R-scan从0.69±0.28降至0.50±0.25(t=-9.01,P=0.00)。上睑MG评分从1.04±0.32降至0.97±0.36(t=-2.14,P=0.03)。下睑MG评分、部分眨眼率、部分眨眼次数和总眨眼次数无明显变化。在OrthoK候选者和OrthoK佩戴者中,DQS治疗1个月后泪膜破裂时间(BUT)和R-scan均有显著改善(均为P=0.00)。在OrthoK佩戴者中,TMH和干眼症状显著增加(均为P=0.00),但在OrthoK候选者中未增加(P>0.05)。未发生与DQS相关的不良事件。
双醋瑞因眼用溶液对佩戴过夜角膜塑形镜的儿童缓解干眼症状和改善眼表参数有效,这可能有助于提高儿童佩戴OrthoK的耐受性和依从性。