摘要
目的探讨不同年龄青少年长期配戴角膜塑形镜眼球参数及泪液的影响。方法选取2017年11月-2018年11月珠海市中西医结合医院眼科进行配戴角膜塑形镜的68例近视青少年为研究对象,根据年龄分为8~10岁组22例、11~13岁组23例和13~16岁组23例,比较不同年龄段青少年在配戴角膜塑形镜配戴前、配戴3个月后、配戴6个月后以及配戴12个月后对眼球参数和泪液影响情况。结果青少年男性眼轴长度和中央前房深度大于青少年女性,差异有统计学意义(P<0.05);不同性别青少年角膜内细胞密度、眼压、中央角膜厚度、屈光度等眼球参数比较,差异无统计学意义(P>0.05)。配戴角膜塑形镜前各年龄段青少年BUT水平相当,配戴角膜塑形镜3个月、6个月、12个月后BUT较配戴前下降,且8~10岁年龄段BUT下降,低于11~13岁组和14~16岁组青少年,差异有统计学意义(P<0.05)。配戴3个月后各年龄段组青少年BUT趋于稳定,差异无统计学意义(P>0.05)。与配戴前比较,配戴后3、6、12个月各年龄段组青少年泪液基础分泌量无明显变化,差异无统计学意义(P>0.05)。各年龄段组青少年相同配戴时间点泪液基础分泌量组间比较,差异无统计学意义(P>0.05),组间差异无统计学意义(P>0.05)。与配戴前比较,配戴12个月后不同年龄段组青年少年眼轴长度、屈光度均减小,差异有统计学意义(P<0.05),组间差异无统计学意义(P>0.05)。8~10岁组眼轴长度程度低于11~13岁组和14~16岁组,组间差异有统计学意义(P<0.05)。与配戴前相比,配戴12个月后各年龄段组青少年角膜内细胞密度、中央前房深度、眼压、中央角膜厚度较配戴前略有降低,差异无统计学意义(P>0.05);配戴角膜塑形镜后的青少年均出现不同程度的角膜上皮点状染色、角膜压痕、视觉异常、角膜病毒感染等并发症,8~10岁组、11~13岁组以及14~16岁组并发症发生率分别为16.67%、36.17%、54.55%,3组间并发症发生率比较差异有统计学意义(P<0.05)。结论长期配戴角膜塑形镜可有效降低青少年屈光度,预防眼轴变长,减缓近视的进展,年龄较小的青少年不宜过早配戴角膜塑形镜,避免对结膜造成损害。
Objective To investigate the effects of long-term wearing of orthokeratology(OK)lens on eye parameters and tears in adolescents of different ages.Methods From November 2017 to November 2018,68 myopic youths who were in the Department of Ophthalmology of Zhuhai Integrated Hospital of Traditional Chinese and Western Medicine were selected as the study objects.According to their ages,they were divided into 22 cases in the 8-10 year-old group,23 cases in the 11-13 year-old group and 23 cases in the 13-16 year-old group.The eyeballs parameters and tear effects of youths in the different ages groups were compared before wearing,3,6 and 12 months after wearing.Results The axial length and the depth of central anterior chamber were significantly higher in adolescent males than in adolescent females(P<0.05).Comparison of intraocular cell density,intraocular pressure,central corneal thickness,diopter and other eye parameters in adolescents of different sex showed no significant difference(P>0.05).The BUT level of adolescents of all age groups before wearing OK lens was the same.After wearing OK lens for 3,6 and 12 months,the BUT level was decreased in 8-10 year-old group,which was lower than that in 11-13 year-old group and 14-16 year-old group(P<0.05).After wearing for 3 months,the BUT levels of all age groups tended to be stable(P>0.05).Compared with that before wearing,there were no significant changes in the basic secretion of tear in all age groups at 3,6 and 12 months after wearing(P>0.05).There was no significant difference between the groups in the amount of basic tear secretion at the same wearing time point(P>0.05),and there was no significant difference between the groups(P>0.05).After 12 months of wearing,the length and diopter of eye axis in the different age groups decreased significantly(P<0.05),but there was no significant difference between the groups(P>0.05).The axial length of 8-10 year-old group was lower than that of 11-13 year-old group and 14-16 year-old group(P<0.05).Compared with before wearing,the cell density,depth of central anterior chamber,intraocular pressure and thickness of central cornea were decreased a little after wearing for 12 months with no statistical significance(P>0.05).After wearing the OK lens,the teenagers had different degrees of corneal epithelial spot staining,corneal indentation,visual abnormalities,corneal virus infection and other complications.The incidence of complications was 16.67%,36.17%and 54.55%in the 8-10 year-old group,11-13 year-old group and 14-16 year-old group respectively.And there was a significant difference among the three groups(P<0.05).Conclusion Long term wearing of orthokeratology lens can effectively reduce the diopter of teenagers,prevent the axial length of eyes from becoming longer,and slow down the progress of myopia.It is not suitable for younger teenagers to wear orthokeratology lens too early to avoid damage to conjunctiva.
作者
段海霞
蒋兆荣
董超
张艺曦
李欢
DUAN Haixia;JIANG Zhaorong;DONG Chao;ZHANG Yixi;LI Huan(Department of Ophthalmology,Zhuhai Integrated Traditional Chinese and Western Medicine Hospital,Guangdong Zhuhai 519020,China)
出处
《新疆医科大学学报》
CAS
2020年第6期777-781,共5页
Journal of Xinjiang Medical University
基金
珠海市卫生局医学科研立项资助项目(2014009)。
关键词
青少年
角膜塑形镜
球参数
泪液
泪液分泌量
眼轴长度
屈光度
adolescents
orthokeratology lens(OK lens)
eyeball parameters
tears
tear secretion
axial length
diopter
