接触镜与泪液形态关系的临床评价  

Clinical evaluation of tear film in patients wearing contact lenses

作　　者：谢培英[1] 王静[1] 姜宏钧[1] 王丹[1] 田欣[1] 郑英德[1] 梁宗钦[1] 

机构地区：[1]北京大学医学部眼视光学研究中心,北京100000

出　　处：《眼视光学杂志》2003年第4期239-241,共3页Chinese Journal of Optometry & Ophthalmology

基　　金：创建世界一流大学计划项目 (北京大学"985"项目 )资助项目

摘　　要：目的 :观察配戴不同种类接触镜后眼表面泪膜的形态、稳定性及泪液量的变化。方法 :对日戴SCL、RGPCL和Ortho KCL的 2 14名近视患者 4 2 8只眼 ,利用表面泪膜观察装置 (DR 1)观察戴镜前后眼表泪液膜和戴镜状态下镜上泪液膜的形态分级 ,同时测定泪膜破裂时间 (BUT)。利用酚红染色棉丝测定SCL戴镜前后的泪液量 ,并用折射仪 (AtagoCL 1)测量SCL含水量的变化。结果 :SCL配戴者随戴镜时间延长 ,BUT明显缩短 (P <0 .0 1) ,RGPCL和Ortho KCL配戴者戴镜 5年以内 ,BUT无明显变化 (P >0 .0 5 )。戴镜后RGPCL ,Ortho KCL和非戴镜正常眼三组间眼表泪膜分级比例差异无显著性 ,SCL组Ⅰ级比例为 6 .5 % ,显著低于其他组(16 .1%～ 2 3.0 % )。镜上泪膜 ,SCL、RGPCL和Ortho KCL三组均以Ⅳ级为主 (分别占 5 4 .4 %、5 3.4 %和 5 1.5 % ) ,SCLⅠ级比例仅 1.9% ,显著低于另二组 (分别占 6 .2 %和 12 .4 % )。SCL配戴者随戴镜时间延长 ,泪液量轻度减少 ,SCL含水量在戴镜 1w后即显著降低。结论 :科学配戴接触镜对泪液膜质量无明显影响 ,但SCL长期使用可能对泪膜有一定干扰作用。Objective:To investigate the pattern and stability of preocular tear film,and changes in tear volume after being fitted with various contact lenses.Methods:214 myopic patients(428 eyes) were fitted with SCL,RGPCL or Ortho-K CL for daily wear. The tear film pattern grades on the corneal and CL surfaces were observed on a DR-1 monitor. BUT,tear volume(pheno red thread) and SCL water content were also measured before and after being fitted for contact lenses.Results:BUT was significantly shorter when the SCL was worn over a long period of time(P<0.01),but there were no significant changes for RGPCL and Ortho-K CL wearers over a 5-year period(P>0.05). There were no significant differences between RGPCL,Ortho-K CL and the control group on the percent of tear film pattern grade on the corneal surface. Grade Ⅰ was 6.5% in the SCL group,which was less marked than for other groups(16.1%～23.0%). Grade Ⅳ was mainly in the SCL,RGPCL and Ortho-K CL groups(54.4%,53.4%,51.5%) from CL surface view. Grade Ⅰ was only 1.9% in the SCL group,which was less marked than for other groups(6.2% and 12.4%). Tear volume decreased slightly for SCL wearers over time. Water content was significantly reduced one week after being fitted for SCLs.Conclusion:Fitting contact lenses does not affect tear film quality or quantity in a measurable way. SCLs may affect tear film health with long-term use.

关 键 词：接触镜 形态学 稳定性 泪膜 泪液量 测定 

分 类 号：R778.3[医药卫生—眼科]