连续配戴软性角膜接触镜对眼表上皮的影响

Effects of extended contact lens wear on the ocular surface epithelium

目的：探讨软性角膜接触镜（soft contact lens,SCL）连续配戴对眼表上皮的影响以及可能机制。方法：将SCL配戴者依据连续戴镜时间分为〈12h组、12－24h组和〉24h组,共3组。对正常对照组（35例70眼）与病例组（99例198眼）进行用角膜荧光素染色（fluores-cein vital staining,FLS）、结膜印迹细胞学检查（conjunctivalimpression cytology,CIC）,对比各组间各观察指标差异。结果：SCL戴镜各组FLS记分、杯状细胞密度与结膜上皮鳞状化分级与正常对照组间差异有统计学意义（P〈0.01）;〈12h组与12－24h组之间,〈12h组与〉24h组之间FLS、杯状细胞密度与结膜上皮鳞状化分级的差异有统计学意义（P〈0.05）;12-24h组与〉24h组之间FLS、杯状细胞密度与结膜上皮鳞状化分级的差异无统计学意义。结论：连续配戴软性角膜接触镜会导致眼表上皮损伤和结膜杯状细胞减少,结膜上皮角化。且持续戴镜时间越长,变化越明显。

·AIM：To observe the effects of extended soft contact lens（SCL）wear on the ocular superficial epithelial and analyze the possible mechanism.·METHODS：The subjects were divided into three groups according to the wearing hours of SCL.Fluorescein vital staining（FLS）,conjunctival impression cytology（CIC）were used in normal control group（35 cases 70 eyes）and experiment group（99 cases 198 eyes）.The differences of FLS,goblet cell density（GCD）and grade of squamous metaplasia were analyzed.·RESULTS：There were statistical differences in FLS,GCD and grade of squamous metaplasia between the group wearing SCL for less than 12 hours,12 to 24 hours or more than 24 hours（P〈0.05）.However,there were no statistical differences in FLS,GCD and grade of squamous metaplasia between the group wearing SCL for 12 to 24 hours and more than 24 hours.·CONCLUSION：Extended SCL wear can cause the ocular surface injury,decrease conjunctival goblet cells and conjunctival epithelium keratinized,and the longer the wear,the obvious the change.·