MacRae S M, Matsuda M, Phillips D S
Casey Eye Institute, Corneal and External Disease Service, Oregon Health Sciences University, Portland 97201-4197.
Ophthalmology. 1994 Feb;101(2):365-70. doi: 10.1016/s0161-6420(94)31327-3.
The purpose of this study is to determine the long-term effects of polymethylmethacrylate (PMMA) contact lens wear on the corneal endothelium. The authors had noted previously advanced polymegethism and decreased cell densities in a few long-term PMMA contact lens wearers. They evaluated a large group of such lens wearers to determine the prevalence of polymegethism and reduced endothelial cell density within this lens-wearing population.
The authors examined the morphologic characteristics of the corneal endothelium in 162 PMMA contact lens wearers or age-matched controls. Eighty-one subjects had worn contact lenses for more than 20 years.
Patients showed advanced polymegethism and pleomorphism compared with controls. Mean cell density in the contact lens-wearing group was not different from controls, but a significantly greater percentage of contact lens wearers (11%, 9 of 81 patients) had cell densities less than 2000 cells/mm2 compared with controls (2.5%, 2 of 81 patients), and were also significantly more likely to have severe polymegethism (coefficient of variation, > 0.60) and severe pleomorphism (frequency of hexagons < 40%).
This study is unique, in that it notes a subgroup of PMMA contact lens wearers who are more susceptible to significant morphometric changes and reduced endothelial cell densities with long-term contact lens use.
本研究旨在确定聚甲基丙烯酸甲酯(PMMA)隐形眼镜佩戴对角膜内皮的长期影响。作者此前注意到一些长期佩戴PMMA隐形眼镜者出现了角膜内皮细胞大小不均一性增加和细胞密度降低的情况。他们评估了一大群此类隐形眼镜佩戴者,以确定在这一佩戴人群中角膜内皮细胞大小不均一性增加和内皮细胞密度降低的发生率。
作者检查了162名PMMA隐形眼镜佩戴者或年龄匹配的对照者的角膜内皮形态特征。其中81名受试者佩戴隐形眼镜超过20年。
与对照组相比,患者出现了更严重的角膜内皮细胞大小不均一性和多形性。隐形眼镜佩戴组的平均细胞密度与对照组无差异,但与对照组(2.5%,81名患者中的2名)相比,显著更多比例的隐形眼镜佩戴者(11%,81名患者中的9名)细胞密度低于2000个细胞/mm²,并且也更有可能出现严重的角膜内皮细胞大小不均一性(变异系数>0.60)和严重的多形性(六边形频率<40%)。
本研究具有独特之处,在于它指出了一部分PMMA隐形眼镜佩戴者,他们在长期使用隐形眼镜后更容易出现显著的形态学变化和内皮细胞密度降低。