配戴角膜塑形镜发生角膜点染危险因素分析及干预措施

Analysis on risk factors for dyed cornea of orthokeratology and interventions

目的探讨配戴角膜塑形镜发生角膜点染的相关危险因素,并对相关危险因素进行统计分析,确定独立危险因素,为制订针对性的干预措施提供参考依据。方法选取2014年5月至2016年5月进行角膜塑形镜验配的990例患者的临床资料,通过查阅病历、跟踪随访、问卷调查等方式找出配戴角膜塑形镜后发生角膜点染不良反应的原因,对相关危险因素进行单因素和多因素Logistic回归分析。结果990例角膜塑形镜验配者中发生角膜点染的有144例,发生率为14.55%;单因素分析发现,角膜塑形镜验配者在性别、年龄、地域、屈光度、镜片位置、家庭成员等方面比较,差异无统计学意义(P>0.05),在既往合并眼部疾病(χ^2= 28.73,P<0.01)、泪液分泌试验(χ^2= 17.68,P<0.01)、镜片活动度(χ^2= 67.1,P<0.01)、镜片沉积物(χ^2= 64.29,P<0.01)、戴镜时间(χ^2=43.25,P<0.01)、卫生习惯(χ^2=38.01,P<0.01)、水源(χ^2=3.81,P<0.05)等方面比较,差异有统计学意义;对单因素有统计学意义的因素进行多因素Logistic回归分析发现患者的泪液分泌情况(OR= 4.126,P=0.003)、镜片活动度(OR=1.733,P=0.104)、镜片沉积物(OR=3.723,P=0.038)、戴镜时间(OR=5.034,P=0.002)、卫生习惯(OR= 6.544,P=0.002)及水源(OR=7.501,P=0.002)是发生角膜塑形镜角膜点染的独立危险因素。结论提高验配技术、彻底清除镜片沉积物、控制戴镜时间,改善患者卫生行为习惯,使用0.9%氯化钠及专业清洗液等干预措施对降低角膜塑形镜不良反应的发生有着重要意义。

Objective To investigate the related risk factors for dyed cornea of orthokeratology, and to analyze the related risk factors, and to determine the independent risk factors, Provide evidence for intervention measures.Methods The clinical date were investigated for 990 patients with fitting orthokeratology lens between may.2014 and may.2016 in our hospital,through access to medical records, follow-up visit,questionnaire investigation to find out the cause of orthokeratology adverse reactions, the related risk factors were analyzed by univariate and multivariate Logistic regression analysis, using SPSS17.0 statistical processing.Results The incidence rate of dyed cornea of orthokeratology lens fitting in was 14.55%(144 in 990 patients); the single factor analysis found gender, age, region, refraction, lens position, family members, no significant difference. Eye disease combined (χ^2= 28.73, P<0.01), Schirmer I test (χ^2= 17.68, P<0.01), lens activity (χ^2= 67.1, P<0.01), Lens deposit (χ^2 =64.29, P<0.01) , lens wearing time (χ^2=43.25, P<0.01), health habits (χ^2=38.01, P<0.01) and water resources (χ^2=3.81,P<0.05), the difference was statistically significant; Logistic Logistic regression analysis found that Schirmer I test (OR=4.126, P=0.003), lens activity (OR=1.733, P=0.104), Lens deposit(OR=3.723, P=0.038), lens wearing time (OR=5.034, P=0.002), health habits (OR= 6.544, P=0.002) and water resources (OR=7.501, P=0.002) were independent risk factors for adverse reactions of orthokeratology.Conclusions Intervention measures that improve the fitting technology, complete removal of lens depositthe, Control wearing time, improve the health behaviors of the patients with the habit, use saline and professional cleaning are of great significance to reduce the incidence of adverse reactions of orthokeratology.