角膜塑形镜治疗前后不同屈光度青少年眼表泪膜的变化

Effect of overnight orthokeratology on tear film stability in myopia juvenile with different diopters

目的观察不同屈光度青少年近视患者夜间配戴角膜塑形镜后的泪膜变化,观察其对眼表泪膜的影响。方法青少年近视患者50例100只眼,按屈光度的不同分为A组(-1.0D^-3.0D)25例50只眼,B组(-3.0D^6.0D)25例50只眼。在戴镜前和戴镜后1周、1个月、3个月、6个月、12个月六个时间点对A、B组进行泪膜破裂时间(BUT)、Schirmer I试验(SIT)、角膜荧光素染色检查(CFS),比较戴镜前后变化。结果所有患者戴镜后各时间点的BUT均较戴镜前明显缩短(P<0.05),各时间点的组间差异无统计学意义(P>0.05);两组戴镜后各时间点SIT数值较戴镜前未见明显变化(P>0.05),各时间点组间比较亦无统计学意义的差异(P>0.05);戴镜后两组各时间点的角膜荧光素染色评分均较戴镜前明显增加(P<0.05),戴镜后各时间组间差异均无统计学意义(P>0.05)。结论青少年佩戴角膜塑形镜后,泪膜稳定性下降,角膜上皮点状荧光素染色增加,但泪液的基础分泌量不受影响且泪膜影响与患者屈光度大小无明显相关性。

Objective： To study the effect of wearing orthokeratology overnight on tear film stability in myopia juvenile with different diopters. Methods： 50 juvenile patients（ 100 eyes） were divided into A Group（-1. 0D ^-3. 0D） and B Group（-3. 0D ~ 6. 0D）. All cases were evaluated by break-up time（ BUT）,schiemer I test（ SIT） and corneal fluorescein staining scores（ CFS） before wearing,and 7 days,1 month,3 months,6 months and 1 year later. Results： In all patients,BUT became shorter after wearing OK lens regardless of the time points（ P〈0. 05）. Otherwise,there were no significant differences between groups at each time point（ P〈0. 05）. The SIT of all cases did not change statistically after wearing（ P〈0. 05） and inter-group comparison at all post-wearing time points showed no significant differences（ P〈0. 05）. The CFS scores of all groups increased significantly（ P〈0. 05） after wearing while comparisons between groups at every post-wearing time point indicated no statistical differences（ P〈0. 05）. Conclusions： The tear film stability decreased after wearing orthokeratology and the basic secretion of tear did not change. And the changes indicated no differences in different diopters juvenile.