夜戴型角膜塑形镜对角膜形态及泪液的影响  

Effect of overnight orthokeratology on corneal topography and tears

作　　者：李健[1] 董平[1] 王承昕 刘虎[1] 

机构地区：[1]南京医科大学第一附属医院眼科,中国江苏省南京市210029

出　　处：《国际眼科杂志》2015年第2期205-207,共3页International Eye Science

摘　　要：目的：探讨夜戴型角膜塑形镜对角膜形态及泪液的影响。方法：连续配戴角膜塑形镜1a以上的青少年近视患者40例80眼,平均年龄13.68±2.32岁,戴镜前平均等效球镜-3.61±1.48D,夜间戴镜8~10h,观察戴镜前和戴镜后1wk;1,3,6,12mo的屈光度、角膜曲率、角膜表面规则指数（SRI）、泪膜破裂时间（BUT）、泪液基础分泌量、角膜上皮荧光素染色的情况。结果：戴镜后12mo与戴镜前相比,屈光度明显降低,平均等效球镜从-3.61±1.48D下降为-1.39±1.31D,差异有显著统计学意义（P〈0.01）;角膜曲率明显变平坦,平均K值从42.29±1.55D下降为40.13±1.41D,差异有显著统计学意义（P〈0.01）;SRI升高,从0.34±0.01增加到0.37±0.01,差异有显著统计学意义（P〈0.01）;BUT减少,从10.39±2.25s下降到7.26±1.77s,差异有显著统计学意义（P〈0.01）;以上指标均在戴镜1wk后趋于稳定,戴镜后1,3,6,12mo各指标与戴镜后1wk相比,差异均无统计学意义（P〉0.05）。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。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. 01）. The corneal curvature was significantly flattened from 42. 29 ± 1. 55D to 40.13±1. 41D （P〈0. 01）. Mean SRl was increased from 0. 34± 0. 01 to 0. 37 ± 0. 01 （ P＆lt;0. 01 ）. Mean BUT was decreased from 10. 39±2. 25s to 7. 26±1. 77s （P〈0. 01）. These indexes were stable at 1wk after wearing OK contact lens overnight and had no significant differences during the following （1, 3, 6, 12mo after wearing） tests （P ＆gt; 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 （P〈0. 05）. CONCLUSlON： OK contact lens can significantly decrease the degree of myopia and K value o

关 键 词：角膜塑形镜 角膜形态 泪液 

分 类 号：R778[医药卫生—眼科]