长期配戴硬性角膜接触镜对泪膜稳定性的影响

Effect of long-term wearing rigid gas permeable contact lenses on the stability of tear film

目的:探讨长期配戴硬性角膜接触镜对泪膜稳定性的影响,观察硬性角膜接触镜长期配戴的安全性。方法:本组观察对象为2014-10/2016-01于我院进行配戴硬性角膜接触镜矫正的近视患者60例120眼以及无硬性角膜接触镜配戴史的低度近视患者30例60眼,将白天配戴RGP的患者26例52眼设为白天配戴组,只在夜间配戴OK镜的患者34例68眼设为夜间配戴组,无硬性角膜接触镜配戴史的低度近视患者30例60眼设为对照组。戴镜前、戴镜1、6mo,1、2a进行泪液分泌试验(Schirmer Ⅰ test,SⅠt)、泪膜羊齿状试验以及泪膜破裂时间(breakup time,BUT)检测。结果:白天配戴组与夜间配戴组戴镜后各时间点BUT、SⅠt均较戴镜前降低,且均显著低于对照组,差异有统计学意义(P<0.05),戴镜后6mo,1、2a白天配戴组BUT、SⅠt显著低于夜间配戴组,差异有统计学意义(P<0.05);三组患者配镜前、配镜1、6mo后泪液羊齿状试验分级比较,差异无统计学意义(P>0.05);配镜1、2a白天配戴组与夜间配戴组≥Ⅲ级眼数显著高于对照组,差异有统计学意义(P<0.05);白天配戴组与夜间配戴组组间比较差异无统计学意义(P>0.05)。结论:长期配戴硬性角膜接触镜可使泪液分泌量降低,泪膜稳定性下降。

AIM:To investigate the effect of long-term wearing rigid gas permeable(RGP)contact lenses on the stability of tear film,and to observe its safety.METHODS:Totally 60 myopia patients(120 eyes)wearing RGP in our hospital from October 2014 to January 2016 and 30 low myopia patients(60 eyes)without a history of wearing RGP were selected.There were 26 patients(52 eyes)wearing RGP at daytime were included into daytime wearing group;34 patients(68 eyes)only wearing RGP at night were set as the night wearing group.And patients without wearing RGP were set as control group.Schirmer I test(S It),tear film fern experiments,and break-up time(BUT)of tear film were performed before wearing RGP,wearing for 1mo,wearing for 6mo,wearing for 1a,wearing for 2a,respectively.RESULTS:After wearing RGP,the BUT and S It of daytime wearing group and night wearing group significantly decreased,and were significantly lower than those of the control group at the time points,the difference was statistically significant(P<0.05).After wearing for 6mo,1a and 2a,the BUT and SIt of daytime wearing group was significantly lower than that of the night wearing group,the statistic found significant difference(P<0.05).The three groups had no statistically significant differences in tear fern classification experiment before wearing RGP and wearing for 1 and 6mo(P>0.05).The number of the eyes≥Ⅲin daytime wearing group and night wearing group was significantly higher than that of the control group after wearing for 1 and 2a,the difference was statistically significant(P<0.05),but the difference between daytime wearing group and night wearing group found no significant difference(P>0.05).CONCLUSION:Wearing RGP can result in reducing tear secretion and decreasing the stability of tear film.