长期配戴软性角膜接触镜对角膜神经生长因子与光学质量的影响  

The influence of soft contact lenses on the corneal nerve growth factor and optical quality

作　　者：邵宇豪 李敏[1] 王威 施岳辉 孙丽娜 钱益勇 邹俊 Shao Yuhao;Li Min;Wang Wei;Shi Yuehui;Sun Lina;Qian Yiyong;Zou Jun(School of Medicine,Tongji University,Department of Ophthalmology,Tenth People′s Hospital Affiliated to Tonji University,Shanghai 200072,China)

机构地区：[1]同济大学医学院、同济大学附属第十人民医院眼科,上海200072

出　　处：《中华眼科杂志》2025年第2期104-111,共8页Chinese Journal of Ophthalmology

基　　金：上海市卫生健康委员会临床研究面上项目(202240131)。

摘　　要：目的探讨长期配戴软性角膜接触镜(SCL)的高度近视眼患者在小切口角膜基质透镜取出术(SMILE)前角膜基质中神经生长因子(NGF)与角膜光学质量的相关性。方法回顾性队列研究。纳入2020年12月至2022年10月在上海市第十人民医院接受SMILE的60例高度近视眼患者(120只眼),年龄(30.75±4.37)岁,26例男性和34例女性。根据术前SCL戴镜时长分为3个组:A组(戴镜时间>10年)、B组(戴镜时间≤10年)和C组(未戴镜)各20例。一般检查采集病史并检查裸眼视力、眼压、眼轴长度等参数。采用Pentacam角膜地形图系统测角膜高阶像差,包括总高阶像差及彗差等,并获取角膜不同部分及分层的光密度。角膜基质透镜部分用于免疫荧光检测,部分用于检测NGF水平。结果角膜基质透镜中NGF表达水平随SCL戴镜时间延长呈上升趋势(P<0.05)。A组角膜总高阶像差为(0.39±0.10)μm,水平彗差为(0.17±0.12)μm,均高于C组的(0.33±0.07)和(0.09±0.08)μm。A组角膜中央直径6 mm环形区域的全层光密度(13.64±2.08)和B组角膜中央直径2 mm圆形区域的全层光密度(13.58±1.28)均高于C组(12.74±0.85)(均P<0.05)。A组角膜基质透镜中NGF水平与角膜中央直径6 mm圆形区域内前层和全层的光密度均呈正相关(均P<0.05)。在B组中,角膜基质透镜NGF水平与角膜中央直径6 mm圆形区域内中层和后层的光密度呈现正相关,同时也与直径2 mm圆形区域的中层和后层光密度呈正相关(均P<0.05)。C组角膜基质透镜中NGF水平与角膜中层、后层直径6 mm圆形区域光密度也呈正相关(均P<0.05)。结论长期配戴SCL的高度近视眼患者角膜基质透镜中NGF表达升高,角膜光学质量下降,NGF水平与角膜光密度密切相关。Objective To explore the correlation between the nerve growth factor(NGF)in the corneal stroma and the corneal optical quality in high myopia patients wearing soft contact lenses(SCLs)for a long time before small incision lenticule extraction(SMILE).MethodsA retrospective cohort study was conducted.Sixty high myopia patients(120 eyes)who underwent SMILE in Shanghai Tenth People′s Hospital from December 2020 to October 2022 were included,with an age of(30.75±4.37)years,including 26 males and 34 females.According to the duration of wearing SCLs before surgery,they were divided into three groups:group A(wearing time>10 years),group B(wearing time≤10 years),and group C(without wearing lenses).General examinations were carried out to collect medical histories and parameters,such as uncorrected visual acuity,intraocular pressure,and axial length of the eye.The Pentacam corneal topography system was used to measure corneal higher-order aberrations,including total higher-order aberrations and various coma aberrations,and to obtain the optical density of different parts and layers of the cornea.A part of the corneal stromal lenticule was used for immunofluorescence detection,and another part was used to detect the NGF level.ResultsThe expression level of NGF in the corneal stromal lenticules showed an upward trend with the prolongation of the wearing time of SCLs(P<0.05).The total higher-order aberration in group A was(0.39±0.10)μm,and the horizontal coma aberration was(0.17±0.12)μm,both higher than those in group C[(0.33±0.07)μm and(0.09±0.08)μm].The full-thickness optical density of the central 6-mm annular region of the cornea in group A(13.64±2.08)and that of the central 2-mm circular region of the cornea in group B(13.58±1.28)were both higher than that in group C(12.74±0.85)(all P<0.05).The NGF level in the corneal stromal lenticules in group A was positively correlated with the optical density of the anterior layer and the full-thickness layer within the central 6-mm circular region of the cornea(bot

关 键 词：近视 接触镜 亲水性 神经生长因子 角膜波前像差 角膜基质 角膜外科手术 激光 

分 类 号：R772.2[医药卫生—眼科]