玻璃酸钠滴眼液在角膜塑形镜配戴中对眼表形态和泪液的影响  

Effects of sodium hyaluronate eye drops on ocular surface and tear film with orthokeratology treatment

作　　者：安阳[1] 李威[1] 郑春晖[1] 何伟[1] 卢山[1] 

机构地区：[1]沈阳何氏眼科医院,辽宁省沈阳市110034

出　　处：《眼科新进展》2016年第1期74-77,共4页Recent Advances in Ophthalmology

摘　　要：目的评价在配戴角膜塑形镜中使用1 g·L-1玻璃酸钠滴眼液(不含防腐剂)对眼表形态和泪液的影响。方法来我院门诊就诊的近视患者59例(118眼),均接受正规角膜塑形镜验配,并随机分为观察组29例(58眼)及对照组30例(60眼),观察组使用不含防腐剂的1 g·L-1玻璃酸钠滴眼液戴摘眼镜,对照组使用舒润液(博士伦)。分别于戴镜前和戴镜后1 d、1周、1个月、3个月时进行视力(log MAR)、TMS-4角膜地形图、基础泪液分泌量、泪膜破裂时间(tear break-up time,TBUT)以及角膜上皮荧光素染色的检测。结果观察组戴镜后1 d的视力(log MAR)为0.20±0.15,高于对照组0.26±0.20(P<0.05);1周后两组视力均恢复平稳,戴镜后1周、1个月、3个月视力(log MAR)两组内比较差异均无统计学意义(均为P>0.05)。观察组各时间点的等效球镜度数与对照组比较差异均无统计学意义(均为P>0.05),戴镜1周后两组等效球镜度数趋于平稳。观察组戴镜后1 d角膜表面规则指数(0.49±0.22)明显低于对照组(0.64±0.32,P<0.05),其他时间点两组间比较差异均无统计学意义(均为P>0.05)。观察组各时间点平均曲率值、角膜偏心率(e值)、基础泪液分泌量与对照组比较差异均无统计学意义(均为P>0.05)。观察组戴镜后各时间点BUT分别为(6.86±1.82)s、(6.04±1.57)s、(6.30±1.41)s、(6.61±1.49)s,对照组分别为(5.50±1.72)s、(5.35±1.41)s、(5.44±1.03)s、(5.32±1.71)s,观察组戴镜后各时间点BUT均高于对照组(均为P>0.05)。观察组的角膜上皮荧光素染色级别在戴镜后各时间点均低于对照组(均为P<0.05)。结论 1 g·L-1玻璃酸钠眼液(不含防腐剂)在角膜塑形镜配戴早期可使角膜塑形更规则,从而改善角膜光滑度。在角膜塑形镜配戴过程中可以稳定泪膜,对角膜上皮起到保护和修复作用。Objective To study the effects of sodium hyaluronate eye drops on the ocular surface and tear film with orthokeratology treatment.Methods Fifty-nine myopic patients（118eyes） were selected in this study,all of them accepted vision correction by orthokeratology lens.They were divided into two groups randomly：Observation group（29 cases,58 eyes） and control group（30 cases,60 eyes）.The observation group was given preservative-free sodium hyaluronate eye drops（1 g · L^-1） when the patients wore the lens,while the control group was given rewetting drops（BOSTON）.The vision（logMAR）,subjective refraction,corneal topography,tear film break-up time（TBUT）,Schirmer I test and fluorescein stain of corneal epithelium before and 1 day,1 week,1 month,3 months after wearing the lens.Results The visual acuity at 1 day after wearing the lens was（0.68 ±0.22） LogMAR in the observation group,which was higher than that of the control group（0.59± 0.27） LogMAR（P〈 0.05）;The visual acuity in two groups were both stable at 1 week after wearing the lens,but there was no statistically significant difference between two groups at 1 week,1 month and 3 months after wearing the lens（all P〉0.05）.There was no statistically significant difference in spherical equivalent refraction at each time point after wearing the lens between the observation group and the control group（all P〈0.05）,and the spherical equivalent refraction of two groups at 1 week after the treatment was stable.The corneal surface regularity index at 1 day after wearing the lens was 0.49 ± 0.22 in the observation group,which was significantly lower than that of the control group（0.64 ±0.32）（P〈0.05）,but there was no statistically significant difference between two groups at 1 week,1 month and 3 months（all P〉0.05）.There was no statistically significant difference in average K value and corneal eccentricity（e value） at 1 day,1 week,1 month and 3 months after wearing the lens between the observation group and

关 键 词：角膜塑形镜 玻璃酸钠滴眼液 泪膜 

分 类 号：R965.3[医药卫生—药理学]