夜戴型角膜塑形镜对儿童眼表症状和体征的影响

发布时间：2018-09-14 20:23

【摘要】：目的:评价夜戴型角膜塑形镜对儿童眼表症状和体征的影响。方法:观察29例(55眼)夜戴型角膜塑形镜佩戴者。分别于戴镜前、戴镜后1周、戴镜后1月、戴镜后2月、戴镜后3月行眼表疾病指数问卷评分(ocular surface disease index,OSDI),泪湖高度、平均非侵入性泪膜破裂时间(average noninvasive tear film breakup time,A-NIBUT)、眼红指数、角膜地形图、角膜荧光染色和SchirmerI试验检查。使用SPSS22.0分析处理数据,使用非参数检验比较各指标差异。结果:与基线(戴镜前)相比,A-NIBUT在戴镜后2月和3月显著下降(P0.05)。眼红指数在戴镜后3月显著升高(P0.05)。角膜荧光染色评分在戴镜后1周、1月、2月和3月显著升高(P0.05)。OSDI评分、泪湖高度和SchirmerI试验与基线相比无显著差异(P0.05)。与基线相比,戴镜后各时间点平均角膜曲率和e值与基线相比显著下降(P0.05)。相反地,角膜表面变异指数(index of surface variance,ISV)和角膜垂直非对称指数(index of vertical asymmetry,IVA)在戴镜后各时间点显著升高(P0.05)。戴镜后,A-NIBUT的变化量与平均角膜曲率、e值、ISV和IVA的变化量没有相关性(P0.05)。与低度近视比,中度近视组戴镜前后角膜曲率、e值、ISV和IVA的变化量更大,差异有统计学意义(P0.05)。低度近视组与中度近视组戴镜前后在A-NIBUT、眼红指数、角膜荧光染色的变化量无显著差异(P0.05)。结论:1.儿童短期佩戴夜戴型角膜塑形镜不会引起接触镜相关不适。2.儿童短期佩戴夜戴型角膜塑形镜不会降低下泪湖容积、泪液基础分泌量,但是会降低泪膜的稳定性和增加角膜荧光染色评分。3.与低度近视组相比,儿童短期佩戴夜戴型角膜塑形镜会增加中度近视组角膜形态的变化特别是角膜不规则性,但是不会加重其眼表损害。
[Abstract]:Objective: to evaluate the effect of night-wear keratoscopy on children's ocular surface symptoms and signs. Methods: a total of 29 cases (55 eyes) were observed. The ocular surface disease index (ocular surface disease index,OSDI), the height of lacrimal lake, the mean time of non-invasive tear film rupture (average noninvasive tear film breakup time,A-NIBUT), and the eye red index (average noninvasive tear film breakup time,A-NIBUT) were measured before, 1 week, 1 month, 2 months and 3 months, respectively. Corneal topography, corneal fluorescence staining and SchirmerI test. SPSS22.0 was used to analyze and process the data, and non-parametric test was used to compare the difference of each index. Results: compared with baseline (pre-mirror), A-NIBUT decreased significantly in 2 and 3 months (P0.05). Eye red index increased significantly 3 months after wearing glasses (P0.05). The corneal fluorescent staining score increased significantly at 1 week, 1 month, 2 months and 3 months after the use of lens (P0.05). There was no significant difference in OSDI score, lacrimal lake height and SchirmerI test compared with baseline (P0.05). Compared with the baseline, the mean corneal curvature and e value at each time point after wearing the lens decreased significantly compared with the baseline (P0.05). On the contrary, the corneal surface variation index (index of surface variance,ISV) and the corneal vertical asymmetry index (index of vertical asymmetry,IVA) were significantly increased at each time point after wearing the lens (P0.05). There was no correlation between the change of A-NIBUT and the mean curvature of cornea (P 0.05). Compared with low myopia, the changes of corneal curvature and IVA were more significant in moderate myopia group before and after wearing lens (P0.05). There was no significant difference in A-NIBUTT, eye red index and corneal fluorescence staining between low myopia group and moderate myopia group (P0.05). Conclusion 1. Short-term wearing of night-wearing keratoplastic lenses in children will not cause contact lens-related discomfort. 2. Children wearing overnight keratoplasty did not decrease lacrimal lake volume and tear basal secretion, but decreased the stability of tear film and increased corneal fluorescent staining score. 3. Compared with the group of low myopia, the short-term wearing of night-wearing keratoplastic lens in children increased the changes of corneal morphology, especially the irregularity of cornea, but did not aggravate the damage to the ocular surface in the group of moderate myopia.
【学位授予单位】：福建中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R778.11

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