夜戴型角膜塑形镜对角膜形态及泪液的影响

摘要

To study the effect of wearing overnight orthokeratology ( OK) contact lens on corneal topography and tears in adolescents.METHODS: The diopter, corneal curvature, corneal surface regularity index ( SRl ) , tear break - up time ( BUT ) , Schirmer l test, and corneal fluorescent ( FL ) were recordedon 40 (80 eyes) adolescent myopia patients (mean age 13. 68±2. 32 years), who had worn OK contact lensfor more than 1 year, with mean spherical equivalent refraction -3. 61 ± 1. 48D before wearing OK contact lens. These indexes were tested and recorded before the patients' wearing OK contact lens and 5 times (1wk and 1, 3, 6, 12mo after the first wearing) during the patients' overnight wearing OK contact lens for 8~10 hours per day.RESULTS: Compared with pre - wearing, at post -wearing OK contact lens 12mo, the mean spherical equivalent refraction was apparently decreased from -3.61±1. 48D to -1. 39±1. 31D(P 0. 05 ). There were no significant differences on Schirmer▏test during the 12mo of OK wearing(P>0. 05). The cases of corneal fluorescent staining increased were mainly grade l, and the number of corneal staining grade l at 1 wk and 1, 3, 6, 12 mo after wearing were 15 eyes (18. 8%), 9 eyes (11. 3%),13 eyes (16. 3%), 9 eyes (11. 3%), and 12 eyes (15. 0%). BUT of corneal staining grade l wasdecreased significantly, compared with the BUT of corneal staining grade 0 during the 12mo of OK wearing (P0.05)。泪液基础分泌量戴镜前后各时间点比较,差异均无统计学意义(P>0.05)。戴镜后角膜上皮染色病例数增加,以Ⅰ级为主,戴镜后1wk；1,3,6,12mo角膜染色Ⅰ级分别为15眼(18.8%),9眼(11.3%),13眼(16.3%),9眼(11.3%),12眼(15.0%)。戴镜后各时间点,角膜荧光素染色Ⅰ级者的BUT均比0级者显著降低(P<0.05)。结论：夜戴型角膜塑形镜可使近视度下降,角膜变平坦,不影响泪液的基础分泌,但泪膜稳定性下降,应注意定期随访。