比较专业护理和自我护理隐形眼镜与非隐形眼镜佩戴者的并发症和依从性。
Complications and compliance in professionally-managed and self-managed contact lenses compared with non-contact lens wearers.
机构信息
Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, ISRAEL.
Southern California College of Optometry at Marshall B. Ketchum University, Fullerton, CA, United States of America.
出版信息
PLoS One. 2024 Sep 6;19(9):e0308538. doi: 10.1371/journal.pone.0308538. eCollection 2024.
PURPOSE
To test the impact of professional management of soft contact lens wear on symptoms and ocular complications.
METHODS
Subjective symptoms and ocular complications of soft CL users who did not seek professional follow-up care (self-managed, SM), were compared to users who were prescribed CLs and their care professionally managed in optometry practices (PM), and to a control group of non-CL wearers. Habitual visual acuity, subjective dry-eye symptoms, and corneal abnormalities were assessed in all participants. CL wearers filled-out a usage habits questionnaire, and their CL fit was assessed. Outcomes were compared using Kruskal-Wallis and Chi Squared tests.
RESULTS
The SM, PM, and non-CL wearers cohorts included 127 (mean age:24.3±5.1, median:23, range:16-45 years,104 female), 132 (mean age:25.5±6.2, median:23, range:18-43 years,103 female), and 56 (mean age:22.3±3.5, median:21, range:18-39 years,36 female) participants, respectively. Meibomian gland dysfunction grade (p = 0.004, p<0.0001), limbal redness (both p = 0.04), corneal neovascularization (both p = 0.003), and papillary conjunctivitis (p<0.0001,p = 0.005) were significantly worse in SM CL wearers compared with both the non-CL wearers and PM CL wearers, respectively. Conjunctival staining was significantly worse in the SM cohort compared with the PM cohort (p = 0.01). 38.6% of the SM compared with 22.8% of the PM CL wearers, had an inappropriate refractive correction (p = 0.006). SM CL wearers wore CLs significantly more years (mean and median 1 year,p = 0.008), for more daily hours (mean and median of 2 hours,p<0.00001), and tended to nap or sleep with their CLs compared with the PM CL wearers (47 vs. 29,p = 0.02). The cohorts did not differ in their subjective symptoms.
CONCLUSIONS
Complications are significantly more prevalent in SM CL wearers compared with PM CL wearers, and SM CL wearers tend to wear CLs with incorrect powers, and are less compliant with napping or sleeping with the CLs compared with PM CL wearers. These findings emphasize the importance of fitting, patient education and follow-ups in CL wearers.
目的
测试软性隐形眼镜佩戴的专业管理对症状和眼部并发症的影响。
方法
将未寻求专业随访护理（自我管理，SM）的软性隐形眼镜使用者的主观症状和眼部并发症与在配镜实践中规定隐形眼镜并对其护理进行专业管理的使用者（PM）以及不佩戴隐形眼镜的对照组进行比较。所有参与者均评估了习惯性视力、主观干眼症症状和角膜异常。隐形眼镜佩戴者填写了使用习惯问卷，并评估了他们的隐形眼镜适配度。使用 Kruskal-Wallis 和卡方检验比较结果。
结果
SM、PM 和不佩戴隐形眼镜的参与者队列分别包括 127 名（平均年龄：24.3±5.1，中位数：23，范围：16-45 岁，104 名女性）、132 名（平均年龄：25.5±6.2，中位数：23，范围：18-43 岁，103 名女性）和 56 名（平均年龄：22.3±3.5，中位数：21，范围：18-39 岁，36 名女性）参与者。睑板腺功能障碍等级（p = 0.004，p<0.0001）、角膜缘充血（均 p = 0.04）、角膜新生血管形成（均 p = 0.003）和乳头性结膜炎（p<0.0001，p = 0.005）在 SM 隐形眼镜佩戴者中明显比不佩戴隐形眼镜者和 PM 隐形眼镜佩戴者更严重。与 PM 组相比，SM 组的结膜染色明显更严重（p = 0.01）。与 PM 隐形眼镜佩戴者相比，38.6%的 SM 隐形眼镜佩戴者的屈光矫正不当（p = 0.006）。SM 隐形眼镜佩戴者佩戴隐形眼镜的年限明显更长（平均和中位数为 1 年，p = 0.008），每天佩戴时间更长（平均和中位数为 2 小时，p<0.00001），且与 PM 隐形眼镜佩戴者相比，更倾向于佩戴隐形眼镜午睡或睡觉（47 比 29，p = 0.02）。这些队列在主观症状方面没有差异。
结论
与 PM 隐形眼镜佩戴者相比，SM 隐形眼镜佩戴者的并发症明显更为普遍，并且 SM 隐形眼镜佩戴者倾向于佩戴屈光不正的隐形眼镜，且与 PM 隐形眼镜佩戴者相比，他们午睡或睡觉时佩戴隐形眼镜的依从性较低。这些发现强调了在隐形眼镜佩戴者中进行配镜、患者教育和随访的重要性。
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