方法：采用前瞻性研究，选取2015-06/08在南京军区南京总医院眼科验配角膜塑形镜的近视儿童23例39眼。观察戴镜前及戴镜后1wk，1、3、6mo时的裸眼视力(uncorrected visual acuity，UCVA)、球镜度数、柱镜度数、SchirmerⅠ试验、泪膜破裂时间(tear break-up time，BUT)、客观散射指数(object scatter index，OSI)、调制传递函数截止频率(modulate transter function cut off，MTF cut off)及客观泪膜质量的变化。

结果：戴镜前及戴镜后1wk，1、3、6mo时的UCVA分别为0.23±0.10、0.81±0.23、0.99±0.11、1.01±0.09、0.95±0.14，戴镜后较戴镜前明显提高，差异有统计学意义(F=723.36，P<0.01)； 戴镜前及戴镜后1wk，1、3、6mo时的球镜度数分别为-2.83±1.34、-0.63±0.82、-0.12±0.20、 -0.03±0.10、-0.10±0.30D，戴镜前后差异有统计学意义(F=107.01，P<0.01)； 戴镜前及戴镜后1wk，1、3、6mo时的柱镜度数分别为-0.12±0.21、-0.13±0.22、-0.12±0.21、-0.14±0.26、-0.21±0.27D，差异无统计学意义(F=2.58，P>0.05)。戴镜前及戴镜后1wk，1、3、6mo时的Schirmer Ⅰ试验结果分别为19.05±3.67、19.13±4.60、17.60±3.39、17.51±2.86、17.56±4.40mm，组间比较差异无统计学意义(F=4.88，P>0.05)； 戴镜前及戴镜后1wk，1、3、6mo时的BUT试验结果分别为11.15±1.81、8.90±1.93、8.31±1.84、7.00±1.78、5.95±1.49s，组间比较差异有统计学意义(F=135.11，P<0.01)。戴镜前及戴镜后1wk，1、3、6mo时的MTF cut off分别为40.89±7.04、33.47±8.61、33.48±7.38、33.08±8.88、33.24±10.31c/deg，OSI值分别为0.40±0.15、0.76±0.38、0.76±0.32、0.86±0.32、0.83±0.51，客观泪膜质量分别为0.80±0.23、1.25±0.51、1.28±0.47、1.29±0.53、1.40±0.65，差异有统计学差意义(F=6.16、19.23、10.62，P<0.01)。

结论：角膜塑形镜可快速降低球镜度数，提高UCVA，对泪液基础分泌无影响，但可以缩短泪膜破裂时间，降低泪膜的稳定性，影响视觉质量。

METHODS:This was a prospective study comprised 23 myopia patients(39 eyes)wearing rigid gas permeable contact lens(RGP)between Jun.2015 and Aug.2015 in the Department of Ophthalmology of Jinling Hospital. Uncorrected visual acuity(UCVA), sphere refractive, cylinder refractive, Schirmer I test, tear film break-up time(BUT), the visual quality and the tear film quality with OQAS II were obtained before and 1wk, 1, 3, 6mo after wearing. The data was analyzed using t-test and One-way.

RESULTS:The UCVA in before and after 1wk, 1, 3, 6mo were 0.23±0.10, 0.81±0.23, 0.99±0.11, 1.01±0.09, 0.95±0.14, the difference was statistically significant(F=723.36, P<0.01). The sphere in before and after 1wk, 1, 3, 6mo were(-2.83±1.34)D,(-0.63±0.82)D,(-0.12±0.20)D,(-0.03±0.10)D,(-0.10±0.30)D respectively, the difference was statistically significant(F=107.01, P<0.01). The refractive cylinder in before and after 1wk, 1, 3, 6mo were(-0.12±0.21)D,(-0.13±0.22)D,(-0.12±0.21)D,(-0.14±0.26)D,(-0.21±0.27)D respectively, there was no significant difference before and after wearing RGP(F=2.58, P>0.05). Schirmer I test showed no statistically significant difference before and after wearing RGP(F=4.88, P>0.05). The stability of tear film was reduced after wearing RGP, and the difference was statistically significant(F=135.11, P<0.01). The modulate transfer function(MTF)cut-off frequency was reduced after wearing RGP, the object scatter index(OSI)was increased after wearing RGP, and the difference was statistically significant, the tear film quality OSI was increased after wearing RGP, and the difference was statistically significant(F=6.16, 19.23, 10.62, P<0.01).

CONCLUSION:The UCVA is significantly increased after wearing RGP. However, there was no significant change in the base-line of tear secretion, but BUT is significantly reduced after wearing RGP. The stability of the tear film is reduced, which can lead to a decline in visual quality.