长期配戴硬性角膜接触镜的效果观察及其对泪膜稳定性的影响

Effect of long一term wear of hard corneal contact lens and its effect on the stability of tear film

目的观察长期配戴硬性角膜接触镜在临床中的应用效果及其对泪膜稳定性的影响。方法选取永康医院2016年4月至2017年4月收治的近视眼患者150例为观察对象,采用随机数字表法分为研究组75例和对照组75例,研究组患者术前长期配戴硬性角膜接触镜,对照组患者术前未配戴硬性角膜接触镜,比较两组患者不同时间段的泪液基础分泌量、泪膜破裂时间(TBUT)以及术后并发症发生情况。结果术后12个月,研究组泪液基础分泌量[(11.1±1.5)mL]明显低于对照组[(18.5±3.2)mL](t=12.235,P<0.05);研究组泪膜破裂时间[(15.8±1.5)min]明显短于对照组[(25.1±4.8)min](t=11.935,P<0.05);研究组干眼症状、角膜染色发生率分别为22.7%、18.7%,均明显低于对照组的33.3%、34.7%,两组差异均有统计学意义(χ^2=5.931、6.425,均P<0.05)。结论长期配戴硬性角膜接触镜严重影响患者的泪液基础分泌量以及泪膜破裂时间,降低了泪膜的稳定性,虽然术后并发症发生率较低,但对泪膜的破坏却无法避免。为了保护泪膜的稳定性,近视眼患者应尽量避免硬性角膜接触镜的配戴,可以选择佩戴框架眼镜。

Objective To analyze the effect of long-term wearing of hard corneal contact lens and its effect on the stability of tear film.Methods From April 2016 to April 2017,150 patients of myopia in Yongkang Hospital were selected in this study and randomly divided into study group and control group,with 75 cases in each group.The patients in the study group wore hard corneal contact lens for a long time before operation,the patients in the control group had no hard comeal contact lens before operation.The basal tear secretion amount,tear film break-up time(TBUT)and the incidence of postoperative complications were compared between the two groups.Results One year after operation,the basal tear secretion amount of the study group[(11.1±1.5)mL]was significantly lower than that of control group[(18.5±3.2)mL](t=12.235,P<0.05).The TBUT of the study group[(15.8±1.5)min]was significantly shorter than that of the control group[(25.1±4.8)min](￡=11.935,P<0.05).The incidence rates of dry eye,corneal staining in the study group were 22.7%,18.7%,respectively,which were significantly lower than those in the control group(33.3%,34.7%),there were statistically significant differences between the two groups(Х^2=5.931,6.425,all P<0.05).Conclusion Long-term wearing hard contact lens seriously affects the tear secretion and TBUT,and reduces the stability of tear film.Although the incidence of postoperative complications is low,tear film damage can not be avoided.In order to protect the stability of the tear film,the patients with myopia should try to avoid the wear of the hard corneal contact lens and choose to wear frame glasses.