单眼佩戴角膜塑形镜对眼表功能和视觉质量的影响  

Effects of Monocular Wear of Orthokeratology Lenses on Ocular Surface Function and Visual Quality

作　　者：郭晨玟 李娟 程方圆 李朝辉 朱涛[1] 汪亮 Guo Chenwen;Li Juan;Cheng Fangyuan;Li Zhaohui;Zhu Tao;Wang Liang(School of Medicine,Anhui University of Science and Technology,Huainan,Anhui 232000,China;Center of Optometry,Wuhu Eye Hospital,Wuhu,Anhui 241000,China)

机构地区：[1]安徽理工大学医学院,安徽淮南232000 [2]芜湖市眼科医院视光中心,安徽芜湖241000

出　　处：《大理大学学报》2025年第4期46-51,共6页Journal of Dali University

基　　金：芜湖市卫生健康委员会科研项目(WHWJ2021y090);安徽省教育厅质量工程项目(2021xqhzsjjd029)。

摘　　要：目的:探讨短期佩戴角膜塑形镜对单眼近视儿童眼表功能及视觉质量的影响。方法:随机选取2023年12月至2024年6月在芜湖市眼科医院就诊的单眼近视儿童52例纳入研究,将其近视眼设为观察组(佩戴角膜塑形镜),对侧非近视眼设为对照组(未佩戴角膜塑形镜)。评估双眼的裸眼视力、眼表功能指标及视觉质量指标,并分析眼部不适症状的影响因素。结果:观察组佩戴角膜塑形镜后裸眼视力维持在1.0及以上,眼表疾病指数(OSDI)评分随时间显著增加,泪膜破裂时间较基线水平显著下降(P<0.05),但泪河高度无显著变化(P>0.05)。戴镜后,斯特列尔比和调制传递函数显著下降,总高阶像差、总球面像差、总彗差显著增加,以第1周变化最为显著(P<0.01),随后趋于稳定,而总三叶草差无显著变化(P>0.05)。OSDI评分变化量仅与总彗差增加量呈正相关(P<0.05)。结论:短期佩戴角膜塑形镜可提高裸眼视力,但会引起眼部不适症状增加、泪膜稳定性下降及客观视觉质量下降。眼部不适症状的增加与泪膜稳定性下降无关,而与总彗差增加有关。Objective:To investigate the effects of short-term wear of orthokeratology lenses on ocular surface function and visual quality in children with monocular myopia.Methods:Fifty-two children with monocular myopia who visited Wuhu Eye Hospital from December 2023 to June 2024 were randomly selected for the study.The myopic eyes(wearing orthokeratology lenses)were set as the observation group,and the contralateral non-myopic eyes(not wearing orthokeratology lenses)were set as the control group.The uncorrected visual acuity,ocular surface function indicators,and visual quality indicators of both eyes were evaluated,and the factors influencing ocular discomfort symptoms were analyzed.Results:After wearing orthokeratology lenses,the uncorrected visual acuity in the observation group remained at 1.0 or above.The ocular surface disease index(OSDI)score significantly increased over time,and the tear film break-up time significantly decreased compared to the baseline level(P<0.05),but there was no significant change in tear meniscus height(P>0.05).After lens wear,the Strehl ratio and modulation transfer function significantly decreased,while higherorder aberrations,total spherical aberration,and total coma significantly increased,with the most significant changes observed in the first week(P<0.01),followed by a stabilization trend.However,there was no significant change in total trefoil(P>0.05).The change in OSDI score was positively correlated only with the increase in total coma(P<0.05).Conclusion:Short-term wear of orthokeratology lenses can improve uncorrected visual acuity but may lead to increased ocular discomfort symptoms,decreased tear film stability,and decreased objective visual quality.The increase in ocular discomfort symptoms is not related to the decrease in tear film stability but is associated with the increase in total coma.

关 键 词：单眼近视 角膜塑形镜 眼表功能 视觉质量 自身对照 

分 类 号：R778.1[医药卫生—眼科]