小牛血去蛋白提取物滴眼液在角膜塑形镜早期配戴中对青少年近视患者眼表和泪液的影响

Effects of deproteinized calf blood extract eye drops on ocular surface and tear film at early stage after orthokeratology treatment in young myopic adoescents

目的评价在青少年近视患者配戴角膜塑形镜早期使用小牛血去蛋白提取物滴眼液对眼表和泪液的影响。方法选择2016年6月到10月来我院近视防控门诊就诊并接受角膜塑形镜验配的近视患者59例(118眼),随机分为两组:试验组29例58眼(戴镜后使用小牛血去蛋白提取物滴眼液),对照组30例60眼(不使用任何促进角膜上皮修复的药物)。分别于戴镜前及戴镜后1周、1个月进行角膜表面规则指数(surface regularity index,SRI)、客观散射指数(objective scattering index,OSI)、泪膜脂质层厚度(lipid layer thickness,LLT)、泪膜破裂时间(tear film break-up time,BUT)、角膜上皮荧光素染色检查以及眼表疾病指数(ocular surface disease index,OSDI)问卷调查。结果对照组戴镜后1周和1个月时角膜上皮着染发生率分别为33.3%和26.7%,试验组分别为10.3%和8.6%;两组间各时间点相比差异均有统计学意义(均为P<0.05)。两组在戴镜后1周和1个月的LLT与戴镜前比较差异均无统计学意义(均为P>0.05)。戴镜后1周,两组角膜曲率、BUT均下降,SRI、OSI、OSDI评分均增加(均为P<0.05);戴镜后1周与1个月比较差异均无统计学意义(均为P>0.05)。试验组的角膜曲率、SRI、BUT、LLT、OSI、OSDI评分在各时间点与对照组比较差异均无统计学意义(均为P>0.05)。结论小牛血去蛋白提取物滴眼液在角膜塑形镜配戴早期对角膜上皮起到一定保护和修复作用。

Objective T o investigate the effects of the eye drops containing deproteinized calf blood extract on the ocular surface and tear film at the early stage of orthokeratology treatment in myopic adolescents. Methods T ogether 59 myopia( 118 eyes) w ho received vision correction by orthokeratology lens betw een June 2016 and O ctober 2016 w ere included in this study,and they w ere randomly assigned into tw o groups: the treatment group,29 patients( 58 eyes) receiving the eye drops containing deproteinized calf blood extract to presumably promote the repair of corneal epithelium,and the control group,30 patients( 60 eyes) w ithout receiving such eye drops. For each subject,the surface regularity index( SRI) and objective scattering index( O SI) w ere recorded; lipid layer thickness( LLT) and tear film break-up time( BU T) w ere measured,and finally fluorescein stain of corneal epithelium and the ocular surface disease index( O SDI) questionnaire w ere performed before treatment and 1 w eek and 1 month after lens w earing.Results T he treatment group showed significantly lower rate of corneal staining than the control group at 1 week( 10. 3% vs. 33. 3%,all P < 0. 05) and 1 month after treatment( 8.6% vs. 26. 7%,all P < 0. 05). T here was no significant difference in LLT at 1 week and 1 month after treatment and before treatment( all P > 0. 05). Both corneal curvature and BUT were decreased,while SRI,OSI,and OSDI score were increased significantly after 1-week lens wearing( all P < 0. 05),but there was no significant difference at 1 week and 1 month after lens wearing( all P > 0. 05). Moreover,there was no significant difference in corneal curvature,SRI,BUT,LLT,OSI,and OSDI score at different time points between the treatment group and the control group( all P > 0. 05). Conclusion Eye drops containing deproteinized calf blood extract can protect and repair the corneal epithelium at the early stage of orthokeratology treatment.