摘要
目的探讨儿童配戴不同设计角膜塑形镜后眼表功能及角膜上皮下神经纤维密度(CNFD)变化。方法前瞻性病例对照研究。选择宁波市眼科医院于2021年1~12月配戴角膜塑形镜儿童78例(148只眼)作为研究对象。采用随机数字表法分为CRT组为研究组,VST组为对照组,比较两组配戴戴前、配戴后1个月、3个月、6个月、1年非侵入性泪膜破裂时间(NIBUT)、泪河高度(TMH)、CNFD,眼表疾病指数(OSDI)问卷评分量表及配戴视觉模拟评分(VAS)评估。结果CRT组和VST组配戴后NIBUT、TMH比较差异均无统计学意义(均P>0.05)。两组组内配戴后1个月、3个月、6个月、1年NIBUT、TMH低于配戴前(均P<0.05);配戴后3个月、6个月、1年NIBUT高于配戴后1个月(均P<0.05)。其他时间点两组比较差异无统计学意义。CRT组和VST组CNFD比较无统计学意义(P>0.05),各组内配戴前和配戴后1个月、3个月、6个月、1年CNFD两组比较差异均有统计学意义(均P<0.05)。OSDI问卷评分量表两组配戴1年比较差异有统计学意义(P<0.05),其他时间点两组比较均无统计学意义(均P>0.05),两组组内配戴后1个月、3个月、6个月、1年OSDI问卷评分高于配戴前(均P<0.05)。两组配戴VAS评估,两组比较差异有统计学差异(P<0.05)。各组内配戴后1个月、3个月、6个月、1年较试戴当时VAS评分低(均P<0.05)。结论两组角膜塑形镜均影响眼表功能,且基本一致,但CRT周边切线设计,材料透氧性高,在干眼症状及舒适性上明显优于VST。
Objective To investigate changes in ocular surface function and sub-basal corneal nerve fiber density in children wearing different designs of orthokeratology lenses.Methods A prospective case-control study.78 children(148 eyes)who wore orthokeratology lenses at Ningbo Eye Hospital from January 2021 to December were collected,and randomly divided into two groups:the corneal refractive therapy(CRT)group(study group)and the vision shaping treatment(VST)group(control group).The study compared non-invasive tear break-up time(NIBUT),tear meniscus height(TMH),corneal nerve fiber density(CNFD),ocular surface disease index(OSDI)questionnaire scores,and visual analog scale(VAS)scores before and at 1 month,3 months,6 months,and 1 year after wearing the lenses.Results There were no significant differences in NIBUT and TMH between the CRT and VST groups after wearing the lenses(P>0.05).In both groups,NIBUT and TMH were significantly lower at 1 month,3 months,6 months,and 1 year after wearing the lenses compared to before wearing them(all P<0.05).NIBUT at 3 months,6 months,and 1 year was higher than at 1 month after wearing the lenses(all P<0.05),with no significant differences at other times.There were no significant differences in CNFD between the CRT and VST groups(all P>0.05).However,within each group,CNFD at 1 month,3 months,6 months,and 1 year after wearing the lenses was significantly different compared to before wearing them(all P<0.05).The OSDI questionnaire scores showed significant differences between the two groups at 1 year after wearing the lenses(P<0.05)but not at other times(all P>0.05).In both groups,OSDI scores were higher at 1 month,3 months,6 months,and 1 year after wearing the lenses compared to before wearing them(all P<0.05).The VAS scores showed significant differences between the two groups(all P<0.05).Within each group,VAS scores at 1 month,3 months,6 months,and 1 year after wearing the lenses were lower compared to the initial trial period(all P<0.05).Conclusions Both types of orthokeratology lenses affected ocular surface function similarly.However,the CRT lenses,with their tangential peripheral design and higher oxygen permeability material,provided better comfort and reduced dry eye symptoms compared to the VST lenses.
作者
金霞
龚燕
王莹
郭晓红
张晓瑾
Jin Xia;Gong Yan;Wang Ying;Guo Xiaohong;Zhang Xiaojin(Ningbo Eye Hospital,Ningbo 315040,Zhejiang Province,China)
出处
《临床眼科杂志》
2025年第4期328-334,共7页
Journal of Clinical Ophthalmology
基金
浙江省医药卫生科技计划(2023KY1141)。
关键词
儿童:角膜塑形镜
眼表功能
角膜上皮神经纤维密度
Children
Orthokeratology lenses
Eye surface function
Corneal epithelial nerve fiber density
