夜戴型角膜塑形镜对青少年角膜泪膜的影响

发布时间：2018-11-16 12:06

【摘要】：目的观察不同屈光度青少年近视患者夜间配戴角膜塑形镜后的泪膜变化,了解其对角膜泪膜的影响。方法采用自身对照研究,收集2014年1月—2015年2月在我院配戴夜戴型角膜塑形镜的青少年近视患者81例158只眼,其中男51例,女30例,年龄8~15岁,平均年龄(13.6±2.2)岁,按屈光度的不同分为A组(-1.00~-2.50 D)38例74只眼,B组(-2.75~-4.00 D)32例61只眼,C组(-4.25~-6.50 D)11例23只眼。在戴镜前,戴镜后7 d,1、3、6个月五个时间点对三组进行干眼症状评分、泪膜破裂时间(BUT)、Schirmer I试验(SIT)、角膜荧光素染色检查,比较戴镜前后变化。结果 1.干眼症状评分:三组患者戴镜后7 d时主观症状评分均较戴镜前增高(P0.05),戴镜后1、3、6个月时的症状评分较戴镜前无明显变化(P0.05);三组戴镜前后各时间点比较,差异均无统计学意义(P0.05)。2.BUT:三组患者戴镜后各时间点的BUT均较戴镜前明显缩短(P0.05),各时间点的组间差异无统计学意义(P0.05)。3.Schirmer I试验:三组戴镜后各时间点SIT数值较戴镜前未见明显变化(P0.05),各时间点组间比较亦无统计学意义的差异(P0.05)。4.角膜荧光素染色评分:三组戴镜后各时间点的角膜荧光素染色评分均较戴镜前明显增加(P0.05),戴镜后各时间组间差异均无统计学意义(P0.05)。结论青少年佩戴角膜塑形镜后,泪膜稳定性下降,角膜上皮点状荧光素染色,但不影响泪液的基础分泌量,戴镜前应重视患者的泪膜相关评估,戴镜后要强调定期复查的重要性。
[Abstract]:Objective to observe the changes of tear film in juvenile myopia patients with different diopters after wearing corneal plastic lens at night. Methods from January 2014 to February 2015, a self-controlled study was conducted to collect 158 eyes of 81 juvenile myopia patients who wore night keratoplasty in our hospital from January 2014 to February 2015, including 51 males and 30 females, aged 815 years, with an average age of (13.6 卤2.2) years. According to the diopter, 38 cases (74 eyes) were divided into group A (-1.00 卤2.50 D), group B (-2.75 -4.00 D), group C (-4.25 卤6.50 D), group C (-4.25 ~ -6.50 D) in 11 cases (23 eyes), group B (-2.75) -4.00 D in 32 cases (61 eyes). Before and 7 days after wearing the lens, the dry eye score and tear film rupture time (BUT), Schirmer I test) of (SIT), corneal fluorescein staining were measured at 5 months and 5 months after wearing the lens, and the changes before and after wearing the lens were compared. Result 1. Dry eye symptom score: the subjective symptom scores of the three groups were higher than those of the pre-mirror patients at 7 days after wearing the mirror (P0.05), and the symptom scores at 1: 3 and 6 months after wearing the mirror had no significant change compared with that before the mirror (P0.05). There was no significant difference between the three groups before and after wearing the mirror (P0.05). 2. The BUT of each time point after wearing the mirror in the three groups was significantly shorter than that before wearing the mirror (P0.05). 3.Schirmer I test: there was no significant change in SIT value at each time point after wearing mirror in three groups (P0.05). There was no significant difference between groups at each time point (P0.05). Corneal fluorescein staining score: the corneal fluorescein staining scores of the three groups were significantly higher than those before the lens wear (P0.05), and there was no significant difference between the three groups (P0.05). Conclusion after wearing corneal plastic lens, the stability of lacrimal film decreased and corneal epithelium was stained with fluorescein, but the amount of tear secretion was not affected, so we should pay attention to the evaluation of tear film before wearing lens. The importance of regular review should be emphasized after wearing glasses.
【作者单位】：成都医学院第一附属医院眼科;
【分类号】：R778.11

【参考文献】