短期夜戴角膜塑形镜后角膜上皮及泪液稳定性的改变  

Changes of corneal epithelium and tear stability after short-term overnight orthokeratology contact lens

作　　者：薛中淇 赵彭彭 孙禹 XUE Zhongqi;ZHAO Pengpeng;SUN Yu(Qingdao Binhai University,Qingdao,Shandong 266555,China;Department of Ophthalmology,the Affiliated Hospital of Qingdao Binhai University/Qingdao Military-Civil Integration Hospital,Qingdao,Shandong 266404,China;Department of Ophthalmology,Qingdao Aier Eye Hospital,Qingdao,Shandong 266520,China)

机构地区：[1]青岛滨海学院,山东青岛266555 [2]青岛滨海学院附属医院/青岛军民融合医院眼科,山东青岛266404 [3]青岛爱尔眼科医院眼科,山东青岛266520

出　　处：《重庆医学》2022年第19期3273-3278,共6页Chongqing medicine

基　　金：山东省医药卫生科技发展计划(202007021427)。

摘　　要：目的观察短期夜戴角膜塑形镜(OK镜)后患者角膜上皮厚度及泪液稳定性改变,评价其在近视治疗中的有效性和安全性。方法选取2020-2021年青岛滨海学院附属医院收治的40例夜戴OK镜治疗近视的青少年右眼,随访3个月,比较患者戴镜前、戴镜后1 d、1周、1个月、3个月的裸眼视力、屈光度、角膜曲率、泪膜破裂时间(TBUT)、基础泪液分泌量、角膜荧光素钠染色等级,同时利用频域光学相干断层扫描(FD-OCT)检测以角膜顶点为中心的环形范围内角膜上皮厚度,对上述参数进行统计分析。结果与戴镜前比较,戴镜后1 d、1周、1个月、3个月患者裸眼视力明显提高,屈光度、角膜曲率明显下降,TBUT明显缩短(P<0.001),基础泪液分泌量无明显变化(P>0.05)。与戴镜前比较,戴镜后1 d中央区角膜上皮明显变薄(P<0.001),反转弧区角膜上皮明显增厚(P<0.001)。角膜曲率、中央区及反转弧区角膜上皮厚度的戴镜前后变化值与屈光度变化值呈线性相关(R 2=0.463,P<0.001;R 2=0.308,P<0.001;R 2=0.251,P=0.006)。戴镜后少部分患者角膜荧光素钠染色等级上升至1级,所有患者无明显上皮损伤及其他并发症发生。戴镜后1 d、1周、1个月、3个月,角膜荧光素钠染色等级为1级的受试眼TBUT较等级为0级的受试眼明显缩短(P<0.001)。结论短期夜戴OK镜矫正近视早期有效,且对于角膜上皮和泪液稳定性而言总体安全。Objective To observe the changes of corneal epithelial thickness and tear stability after wearing the short-term overnight orthokeratology contact lens(OK lens),and to evaluate its effectiveness and safety in treating myopia.Methods The right eyes of 40 adolescents with myopia treated by night wearing OK lens in the Affiliated Hospital of Qingdao Binhai University from 2020 to 2021 were selected,and a 3-month follow-up was conducted.The naked eye visual acuity,diopter,corneal curvature,tear breakup time(TBUT),basal tear secretion and corneal epithelial fluorescein staining grade before wearing OK lens,at 1 d,1 week,1 and 3 months after wearing OK lens were compared.The thickness of corneal epithelium in the annular range centered on corneal vertex was also detected by the frequency-domain optical coherence tomography(FD-OCT).The above parameters were statistically analyzed.Results Compared with before wearing the OK lens,after wearing OK lens the naked eye visual acuity was significantly improved,the corneal curvature and diopter were significantly decreased,the TBUT was significantly shortened(P<0.001),while no statistically significant difference was found in the basal tear secretion amount(P>0.05).Compared with before wearing the OK lens,the corneal epithelial thickness of central zone at 1 d after wearing the OK lens significantly became thinner(P<0.001),and the corneal epithelium thickness of reverse curve zone was significantly thickened(P<0.001).The change in corneal curvature,corneal epithelium thickness of central zone and reverse curve zone before and after wearing OK lens values of were linearly correlated with the change in diopter value before and after wearing OK lens(R 2=0.463,P<0.001;R 2=0.308,P<0.001;R 2=0.251,P=0.006,respectively).The corneal epithelium staining grade after wearing OK lens in a small number of patients was increased to the grade 1,and all patients had no obvious epithelial injury and other complications.TBUT of the patients with corneal epithelial fluorescein staining grade 1 wa

关 键 词：近视 角膜上皮 角膜塑型镜 视力 泪液稳定性 

分 类 号：R779.6[医药卫生—眼科]