角膜接触镜配戴者的戴镜行为及认知的调查分析

Analytical report on the fitting behavior of contact lens wearers based on a survey

目的通过对角膜接触镜经验配戴者进行问卷调查，了解配戴者的戴镜行为、护理习惯以及对角膜接触镜医疗属性的认知程度，探讨提高配戴者戴镜舒适度和安全性的可行性对策。方法调查研究。在上海、北京、广州、深圳、成都和杭州6个城市42家大型眼镜店对角膜接触镜经验配戴者进行调查。调查问卷共28题（分6部分内容），包括：①配戴者基本资料和戴镜史；②当前戴镜行为；③日常护理习惯；④眼科检查和随访复查；⑤对角膜接触镜的认知评估；⑥镜片验配和影响因素。对相关调查数据进行X^2检验。结果本调查共回收到504份有效问卷。①受访者中女性439名（87．1％），男性65名（12．9％），年龄为19—42岁，平均（27．8±7．3岁）；戴镜经验为6个月～12年，平均为（6-3±5．2）年。②6．2％（31／504）受访者戴日戴型镜片过夜，2周和1个月更换型配戴组比日抛组、3-6个月更换组以及〉6个月更换组更遵循更换周期．差异具有统计学意义（X^2=12．32、57．52、45．91，P〈O．01）。③73．O％（368／504）受访者在操作镜片前洗手，54．0％（272／504）受访者有揉搓清洁镜片，38．1％（192／504）受访者使用护理液冲洗镜片。④67．1％（338／504）受访者从未主动随访复查，50．1％（207／413）和37．8％（68／180）受访者对戴镜期间出现的不舒适和眼病曾采用不恰当的处理方法。⑤17．1％（86／504）受访者知晓角膜接触镜为医疗用品，超过6成受访者对角膜接触镜有不同程度的认知错误。⑥63．1％f318／504）受访者将接触镜的价格作为选择镜片的首要影响因素。结论很多配戴者在角膜接触镜使用中存在安全隐患．原因可能是对角膜接触镜医疗属性认知不足，眼保健意识匮乏等。应该普及角膜接触镜配戴护理相关的公众教育，提升验配人员的专业水平以及加强初戴者的安全、规范使用宣教，以提升角膜接触镜的配戴安全性。

Objective To understand the care and fitting habits of contact lens wearers; to evaluate perceptions about contact lens medical features based on Chinese questionnaires answered by experienced contact lens wearers; to try to develop tangible strategies to enhance the safety and comfort of contact lens wearers based on this information. Methods This study was based on an investigative survey. The survey was conducted in 42 big optical stores located in 6 cities： Shanghai, Beijing, Guangzhou, Shenzhen, Chengdu and Hangzhou. The survey targeted experienced wearers. The questionnaire consisted of 28 questions （6 parts） including： ①basic information and lens fitting history of wearers; ②current lens fitting behavior; ③daily lens care procedure; ④eye check and follow-up visits; ⑤assessment of perceptions about contact lenses; ⑥lens selection factors. Data were analyzed with chi-square tests. Results A total of 504 valid survey forms were collected. This study showed the following findings： ①Females, 439（87.1%） and males, 65（12.9%）, age range of 19-42 years with an average age of （27.8±7.3）year. Experience with contact lens wear ranged from 6 months to 12 years, with an average of （6.3±5.2）years; ②6.2%（31/504） of the respondents reported that they slept with their daily wear lenses. The groups of a 2-week and 1-month replacement schedule were significantly more eomoliant than the groups with replacement schedule was daily, 3-6 month, 〉6 month disposablegroup （X^2=12.32, 57.52, 45.91, P〈0.01）. ③73.0%（368/504） washed their hands before handling the lenses, 54.0%（272/500） rubbed and cleaned the lenses, 38.1%（192/500） rinsed them with care solution; ④67.1%（338/504） indicated that they never proactively went for follow-up visits; 50.1% （207/413） and 38.1%（68/180） used an incorrect solution for discomfort and eye disease during the lens wear period; ⑤17.1%（86/504） knew that contact lenses were categorized as a medical device, over 60% of the respondents had misunderstandings about contact lenses; ⑥63.1%（318/504） took lens price as the first priority when selecting specific lenses. Conclusion A wide variety of noncompliance behavior affects the safety of contact lenses. The reasons for incorrect behavior may involve an unawareness about contact lens medical features and lack of eye health and care information, etc. So to enhance the safe use of contact lenses in the future, it is critical to educate the public about lens fitting and care, improve the professionalism of lens fitting staffs and stress the compliance policy for new wearers.