摘要
目的:观察近视儿童青少年过夜配戴角膜塑形镜后眼表相关指标和睑板腺的变化,探讨和评价角膜塑形镜对其眼表和睑板腺的影响。方法:前瞻性队列研究。选择在浙江中医药大学附属第二医院过夜配戴角膜塑形镜的近视患儿60例(60眼)作为塑形镜组,配戴普通框架眼镜患儿60例(60眼)作为框架镜组,2组均在戴镜前,戴镜后1、3、6、12个月进行眼表疾病指数(OSDI)问卷调查;同时使用眼表综合分析仪测得下泪河高度、非侵入式泪膜破裂时间(NIBUT)、角膜染色评分(CSF)、红外线睑板腺图像等眼表指标,比较2组上述各指标差异,总结戴镜后不同时间点指标变化的规律。戴镜前后各值比较采用两因素重复测量方差分析。结果:2组在OSDI评分、下泪河高度等方面差异均无统计学意义。2组不同时间的NIBUT比较,差异有统计学意义(F=6.581,P=0.018;F时间=50.152,组别P<0.001),塑形镜组戴镜前后NIBUT不完全相同(P=0.02),并且在戴镜后6个月和12个月明显缩短,与框架镜组相比有明显差异(均P<0.05),且与组内其他时间点比较差异均有统计学意义(均P<0.05)。2组不同时间的CSF比较,差异有统计学意义(F=1.945,P=0.134;F=68.151,P<0.001)。塑组别时间形镜组戴镜后角膜上皮染色较戴镜前增多,评分均高于框架镜组(χ2=19.511,P=0.013),但各时间点之间比较差异无统计学意义。2组不同时间的睑板腺评分比较,差异有统计学意义(F=2.152,组别P=0.144;F=80.151,P<0.001)。塑形镜组戴镜后1、3、6个月睑板腺总积分与戴镜前相比稍有增时间多,但与框架镜组相比差异无统计学意义,戴镜后12个月的上睑板腺评分和睑板腺总评分明显增高,与框架镜组相比、与同组戴镜前及戴镜后1个月相比差异均有统计学意义(均P<0.05),下睑板腺评分无明显变化。结论:过夜配戴角膜塑形镜是相对安全的,短期不会引起不适感和降低下泪河高度,但是会降低泪膜�
Objective:To investigate the effect of overnight orthokeratology(OOK)on the ocular surface and changes in meibomian gland morphology in children and adolescents with myopia.Methods:In this prospective cohort study,choosing myopia children from the Second Affiliated Hospital of Zhejiang Chinese Medical University,sixty myopic patients(60 eyes)with OOK were selected as the OOK group,and 60 patients(60 eyes)with eye glasses were selected as the glasses group.The following tests were performed before OOK and eyeglass wear and after 1,3,6 and 12 months of wear.Tests included ocular surface disease index(OSDI)questionnaire,noninvasive tear break-up time(NIBUT),tear meniscus height(TMH),corneal epithelial staining(CSF),and meiboscore using noncontact meibography.The effect of OOK wear on the ocular surface and changes that occurred were evaluated and summarized by comparing the differences between these two groups.Results:There were no significant differences in the OSDI score or tear meniscus height between these two groups.The NIBUT of the OOK group showed a significant decrease after 6 and 12 months of lens wear(both P<0.05).There were no statistically significant differences at other time points.Corneal fluorescence staining in the OOK group increased after wearing the lenses(χ2=19.511,P=0.013),but there were no statistically significant differences at the other time points.The score of the meibomian gland orifice in the OOK group was slightly increased before wearing the lenses and after 1,3 and 6 months,but the differences were not statistically significant.The final 12 months were significantly higher than before wearing eye glasses and 1 month after wearing eye glasses,and the difference was statistically significant(P<0.05).Conclusions:It is relatively safe to wear OOK lenses overnight.Shortterm wear of OOK will not cause discomfort and it will not reduce tear meniscus height or the amount of tear secretion in the short term,however,it reduces the stability of the tear film and increases the corneal fluorescen
作者
杨立
俞萍萍
Li Yang;Pingping Yu(The Second Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou 310005,China)
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2020年第1期51-57,共7页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
2018年浙江医药卫生科技计划适宜技术推广申请课题(2018ZH018)。
关键词
角膜塑形镜
眼表
睑板腺
儿童青少年
orthokeratology
ocular surface
meibomian glands
children and adolescents
