配戴角膜塑形镜患者发生角膜上皮点状染色的影响因素

Influencing factors of corneal epithelial punctate staining in patients wearing orthokeratology

目的:探讨配戴角膜塑形镜患者发生角膜上皮点状染色的影响因素。方法:共收集280例配戴角膜塑形镜患者的数据,其中未发生角膜点染组185例,发生角膜点染组95例。对所有参与本次研究的患者进行普通远视力检查、眼压、裂隙灯、散瞳后眼底检查、综合验光、角膜地形图、角膜厚度、角膜内皮、眼轴长度、戴镜前泪液分泌试验(SⅠt)、戴镜前睑板腺缺失评分、偏心距离、泪液中白细胞介素2(IL-2)、肿瘤坏死因子α(TNF-α)含量分析等相关检查。通过单因素和多因素Logistic回归分析探究角膜上皮点状染色的影响因素。结果:两组戴镜前屈光度、戴镜前睑板腺缺失评分、IL-2、TNF-α、镜片沉积物比较均有差异(均P<0.05)。Logistic回归分析结果显示,戴镜前屈光度是患者发生角膜上皮点状染色的保护因素,戴镜前睑板腺缺失评分、IL-2、TNF-α、镜片沉积物是患者发生角膜上皮点状染色的危险因素。结论:戴镜前屈光度是患者发生角膜上皮点状染色的保护因素,戴镜前睑板腺缺失评分、IL-2、TNF-α、镜片沉积物是患者发生角膜上皮点状染色的危险因素。

AIM:To investigate the influencing factors of punctate staining of corneal epithelium in patients wearing orthokeratology.METHOD:Data of 280 cases wearing orthokeratology were collected,including 185 cases in the group without corneal staining and 95 cases in the group with corneal staining.All patients were examined for general distant vision,intraocular pressure,slit lamp,fundus examination after mydriasis,comprehensive optometry,corneal topography,corneal thickness,corneal endothelium,axial length,SchirmerⅠtest(SⅠt)before wearing lenses,meibomian gland loss score before wearing lenses,eccentric distance,interleukin-2(IL-2)in tear,tumor necrosis factor-α(TNF-α)content analysis and so on.The influencing factors of corneal epithelium punctate staining were analyzed by univariate and multivariate Logistic regression.RESULTS:There were significant differences in preoperative diopter,preoperative meibomian gland deletion score,IL-2,TNF-α and lens sediment between the two groups(all P<0.05).Logistic regression analysis showed that diopter before wearing lenses was a protective factor for corneal epithelium punctate staining.Before wearing lenses,the loss of meibomian gland score,IL-2,TNF-α and lens deposits were the risk factors of corneal epithelium punctate staining.In the detection of corneal epithelium punctate staining,the comprehensive advantage of lens deposits was obvious,the specificity of lens deposits was higher,and the sensitivity of IL-2 was the highest.CONCLUSIONS:Before wearing lenses,diopter is the protective factor of corneal epithelium punctate staining,and the loss of meibomian gland score,IL-2,TNF-α and lens deposits are the risk factors of corneal epithelium punctate staining.