短期夜戴角膜塑形镜对成年近视患者泪膜的影响

边思予; 仁千格麦; 何元浩; 王将栏; 杨必; 刘陇黔

doi:10.12182/20200160605

短期夜戴角膜塑形镜对成年近视患者泪膜的影响

The Influence of Short-term Orthokeratology on Tear Film in Adult Myope

摘要

摘要:
目的探讨成年近视患者在短期夜戴角膜塑形镜后泪膜的变化。
方法选取18～38周岁的成年近视患者50例，双眼过夜配戴角膜塑形镜6~10 h。分别于戴镜前和戴镜1 d、7 d、14 d、30 d和90 d测量非侵入性泪膜破裂时间（non-invasive tear break-up time, NITBUT）、侵入性泪膜破裂时间（fluorescent tear break-up time, FTBUT）、下泪河高度（lower tear meniscus height, LTMH）、角膜荧光素钠染色评级和眼表疾病指数（ocular surface disease index, OSDI）问卷得分。
结果 44例受试者完成90 d的随访研究。受试者过夜配戴角膜塑形镜后，泪膜破裂时间（tear break-up time, TBUT）均有所下降，在戴镜14 d后开始趋于平稳；LTMH持续减少，戴镜90 d后与戴镜前比较，差异有统计学意义（P<0.05）；戴镜后角膜上皮点染评级较戴镜前升高（P<0.05）；OSDI得分在戴镜后各时间点与戴镜前相较，差异无统计学意义。
结论成年近视患者短期夜戴角膜塑形镜后泪膜稳定性和泪液分泌量下降，角膜上皮容易出现点染。

Abstract:
Objective To study the changes of tear film after short-term overnight orthokeratology wearing in adult myope.
Methods Fifty adult myope aged 18 to 38 years old were enrolled in this study. The patients wore orthokeratology 6-10 h every night during this study. Data such as non-invasive tear break-up time (NITBUT), fluorescent tear break-up time (FTBUT), lower tear meniscus height (LTMH), corneal fluorescent staining as well as ocular surface disease index (OSDI) questionnaire score were measured at baseline, 1 d, 7 d, 14 d, 30 d and 90 d.
Results Forty-four subjects completed the follow-up study. Tear break-up time (TBUT) decreased and became stable at 14 d after overnight orthokeratology wearing. LTMH sustained decreased and there was a difference after 90 d overnight wearing （P<0.05）. Compared with baseline, the grade of corneal staining increased at all time points （P<0.05）. As for the OSDI score, there was no difference at all time points.
Conclusion After overnight orthokeratology wearing, tear film stability and tear secretion decreased. Adult myope seems easily to suffer corneal injury after overnight orthokeratology wearing.

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