配适度良好青少年夜戴角膜塑形镜期间的泪膜间隙厚度及角膜参数变化  

Observation of tear film thickness and corneal parameters in moderate and good night wearing of orthokeratology

作　　者：王晗敏[1] 周欢明[1] 姚月蓉 赵怡[1] 李青松[1] 田文杰 高翔 贾元玲 项敏泓[1] Han-Min Wang;Huan-Ming Zhou;Yue-Rong Yao;Yi Zhao;Qing-Song Li;Wen-Jie Tian;Xiang Gao;Yuan-Ling Jia;Min-Hong Xiang(Department of Ophthahnology,Putuo Hospital of Shanghai Traditional Chinese Medical Universily,Shanghai 200062,China;Department of Ophthahnology,Baoshan Hospital of Integrated Chinese and Western Medicine,Shanghai 201900,China)

机构地区：[1]上海中医药大学附属普陀医院眼科,中国上海市200062 [2]中国上海市宝山区中西医结合医院眼科,201900

出　　处：《国际眼科杂志》2018年第8期1544-1548,共5页International Eye Science

基　　金：上海市普陀区自主创新科研基金(No.2013PTKW009)~~

摘　　要：目的:测量配适度良好青少年夜戴角膜塑形镜期间的泪膜间隙厚度,并观察角膜参数变化。方法:收集2015-07/2016-08在我院视光学门诊接受配戴OK镜,并坚持规律随访的近视患者26例51眼。配戴前测得等效球镜度数为-1.00～-6.00(平均-2.78±1.53)D,测得散光值为0～-2.68(平均1.29±0.61)D。配戴1mo时采用OCT分别测量左右眼戴镜时的泪膜间隙厚度,比较双眼间泪膜间隙厚度的差异,及其与角膜的表面规则指数(SRI)的关系。并观察戴镜期间角膜前表面参数的变化情况。结果:戴镜1mo时,所有配适度良好的病例右眼测得泪膜间隙厚度为230.09±10.40μm,左眼泪膜间隙厚度为224.38±10.57μm,男性测得平均泪膜间隙厚度为228.75±9.66μm,女性测得平均泪膜间隙厚度为224.80±6.74μm。所有眼的平均泪膜间隙厚度为227.05±10.29μm,平均SRI值为0.16±0.14,两者无相关性(P>0.05)。FK值、SK值及平均K值从戴镜前、戴镜后2d到戴镜1wk时均呈逐渐降低趋势,差异有统计学意义(P<0.05);而从戴镜1wk,1、3、6mo时趋于稳定,差异无统计学差异(P>0.05)。结论:OCT可作为一种安全可靠的、测量戴镜期间泪膜间隙厚度的方法,这对长期配戴OK镜时的安全性评价方面可能具有一定的价值;角膜塑形镜起效很快,配戴2d后角膜曲率即迅速降低,1mo后就能对角膜产生稳定的塑形。AIM： To measure the tear film thickness when with a good fitted night wear orthokeratology lens in youth,and observe the change of corneal parameters.METHODS： From July 2015 to August 2016,51 eyes of 26 teenagers with myopia who would wear orthokeratology and accept regular follow-up were enrolled. The mean spherical equivalent refraction of teenagers was -2. 78D±1. 53D（-1. 00D to -6. 00D） before wearing orthokeratology,and the mean astigmatism was 1. 29D±0. 61D（ 0 to-2. 68D）. The tear film thickness were measured by optical coherence tomography（ OCT） when the eyes wearing orthokeratology for 1 mo. The surface regularity index（ SRI） value was measured by corneal topography to compare its relationship with the tear film thickness and the changes of corneal anterior surface parameters during the period of wearing lens were observed.RESULTS： At 1 mo after wearing orthokeratology,the mean tear film thickness of right eyes was 230. 09 ±10. 40μm,and that was 224. 38±10. 57μm of left eyes. The mean tear film thickness was 228. 75 ± 9. 66μm in male eyes and that was 224. 80±6. 74μm in female eyes. The mean tear film thickness of all eyes was 227. 05 ±10. 29μm,and the mean SRI value was 0. 16±0. 14. There was no correlation between tear film thickness and SRI value（ P〈0. 05）. The FK value,SK value and average K value from before wearing to after wearing for 2 d and1 wk gradually decreased,the difference was statistically significant（ P〈0. 05）. There was no statistical difference among wearing for 1 wk,1,3 and 6 mo（ P〈0. 05）.CONCLUSION： OCT can be used as a safe and reliable method for measuring the thickness of the tear film space during the wearing of orthokeratology,which may be of certain value for the safety assessment of the long term wearing of orthokeratology. Orthokeratology works very quickly,corneal curvature decreases rapidly 2 d after wearing and stabilizes during the period.

关 键 词：角膜塑形镜 光学相干断层扫描 泪膜间隙厚度 配适度 角膜曲率 

分 类 号：R778.11[医药卫生—眼科]