巩膜镜对屈光不正患者中央角膜厚度和内皮细胞的影响  

Effect of Scleral Lens on Central Corneal Thickness and Corneal Endothelial Cells in Patients with Refractive Error

作　　者：许爱琴 陈碧池 田丽 刘善晓 刘璐 姜珺 Aiqin Xu;Bichi Chen;Li Tian;Shanxiao Liu;Lu Liu;Jun Jiang(National Clinical Research Center for Ocular Diseases,Eye Hospital,Wenzhou Medical University,Wenzhou 325027,China;Vision X Medical Technology Co.,Ltd.,Shanghai 201114,China)

机构地区：[1]温州医科大学附属眼视光医院国家眼耳鼻喉疾病临床医学研究中心(眼部疾病),温州325027 [2]上海艾康特医疗科技有限公司,上海201114

出　　处：《中华眼视光学与视觉科学杂志》2023年第9期678-682,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：国家自然科学基金面上项目 (82171016)。

摘　　要：目的:探讨屈光不正患者短期配戴巩膜镜(SL)后中央角膜厚度(CCT)及角膜内皮的变化和影响因素。方法:前瞻性临床研究。随机选取2021年6—9月于温州医科大学附属眼视光医院接受SL进行屈光不正矫正的受检者21例。采用扫频光学相干断层扫描仪,分别在配戴SL的第1天(当天戴镜初始、30 min、1 h、2 h、4 h)与第3个月(当天戴镜初始、4 h)各时间点进行CCT测量。采用角膜内皮细胞计数仪分别在配戴SL前及戴镜3个月后测量角膜内皮细胞密度及进行多形性分级。采用重复测量方差分析、配对t检验和Wilcoxon秩和检验分析戴镜前后各参数变化,多元线性回归分析其影响因素。结果:受检者配戴SL后,随配戴时间延长,CCT逐渐增加。戴镜第1天时的戴镜30 min、1 h、2 h、4 h,CCT增加百分比分别为1.37%、1.39%、1.49%和1.91%,与戴镜初始CCT差异有统计学意义(F=5.40,P=0.004)。戴镜3个月,配戴4 h后CCT增加百分比为1.08%,与当天戴镜初始CCT差异有统计学意义(t=-3.33,P=0.003)。受检者戴镜第1天的初始CCT为(529±27)μm,与戴镜3个月的初始CCT[(529±30)μm]差异无统计学意义(P>0.05)。和戴镜前相比,戴镜3个月角膜内皮细胞密度和多形性变化差异均无统计学意义(均P>0.05)。CCT增加百分比与初始中央镜下液厚度、等效球镜度、年龄以及性别均无相关性(均P>0.05)。结论:短时配戴SL后会引起CCT增加,且增厚量随配戴时间延长而增加,但戴镜4 h后,增厚量小于角膜生理性水肿量。配戴SL 3个月后,当天戴镜初始CCT恢复至3个月前戴镜初始水平。第1天和第3个月同样戴镜4 h后的CCT未发生明显改变。同时短期配戴SL不会对角膜内皮细胞形态产生影响。Objective:To investigate the changes in central corneal thickness(CCT)and corneal endothelial cells in patients with refractive error after short-term wearing of the scleral lens(SL)and the influencing factors.Methods:Prospective clinical study.Twenty-one subjects who received SL for refractive error correction in the Eye Hospital of Wenzhou Medical University from June 2021 to September 2021 were randomly selected.The CCT was measured by swept-source optical coherence tomography at different time points on the first day after wearing SL(immediately,30 minutes,1 hour,2 hours,and 4 hours after lens insertion)and after three months(immediately and 4 hours after lens insertion).The corneal endothelial cell density and pleomorphic grading were measured using the endothelial cell enumerator before and after 3 months.Repeated measures analysis of variance,paired t-test and Wilcoxon rank sum test were used to analyze the changes of each parameter before and after wearing scleral lens,and multiple linear regression was used to analyze the influencing factors.Results:The CCT gradually increased with the extension of wearing time.At 30 minutes,1 hour,2 hours,and 4 hours on the first day after wearing SL,the percentage increase of CCT was 1.37%,1.39%,1.49%,and 1.91%,respectively,and the difference was statistically significant compared with the initial CCT before wearing the lens(F=5.40,P=0.004).After 3 months,the percentage increase of CCT was 1.08%after wearing 4 hours comparing with the initial CCT on the same day(t=-3.33,P=0.003).There was no significant difference between the initial CCT(529±27μm)on the first day and the initial CCT(529±30μm)after 3 months(P>0.05).The differences in corneal endothelial cell density and pleomorphism before and after wearing SL for 3 months were not significantly(all P>0.05).There was no correlation between the amount of CCT thickening and initial post-lens tear thickness,spherical equivalent,age,and gender(all P>0.05).Conclusions:Short-term wearing of SL would cause an increase in C

关 键 词：屈光不正 巩膜接触镜 中央角膜厚度 角膜内皮 

分 类 号：R778[医药卫生—眼科]