不同年龄段儿童青少年配戴角膜塑形镜对眼表和睑板腺的影响

Effects of wearing orthokeratology lens on ocular surface and meibomian gland in children and adolescents of different ages

摘要:

目的：探讨不同年龄段近视儿童青少年配戴角膜塑形镜对眼表和睑板腺的影响。方法：回顾性选取2020-12/2021-02于我院眼视光门诊就诊的近视儿童青少年患者120例240眼，根据近视矫正方式分为角膜塑形镜组(60例120眼)和框架眼镜组(60例120眼)。分析两组患者戴镜前后眼表和睑板腺的变化，并对比两组中不同年龄段患者戴镜前后眼表和睑板腺的变化。结果：与戴镜前比较，角膜塑形镜组戴镜后3、6、9、12mo角膜曲率降低、非侵入式泪膜破裂时间(NIBUT)缩短、睑板腺评分升高，戴镜后6、9、12mo下泪河高度升高，而框架眼镜组戴镜后6、9mo下泪河高度升高(均P<0.05)。角膜塑形镜组戴镜后3、6、9、12mo角膜曲率明显低于框架眼镜组，戴镜后3、9、12mo NIBUT短于框架眼镜组，戴镜后6、9、12mo睑板腺评分高于框架眼镜组(均P<0.05)。戴镜12mo，角膜塑形镜组各年龄段患者角膜曲率显著低于框架眼镜组，而8～12、13～15岁年龄段患者NIBUT显著低于框架眼镜组，且睑板腺评分显著高于框架眼镜组(均P<0.05)。 结论：配戴角膜塑形镜可能会影响眼表和睑板腺功能，其对年龄12岁以下的儿童青少年的眼表影响更明显，因此年龄较小的儿童青少年可优先考虑配戴框架眼镜矫正近视，待年龄增加再考虑配戴角膜塑形镜进行干预。

Abstract:

AIM: To investigate the effect of orthokeratology lens on ocular surface and meibomian gland in children and adolescents of different ages.METHODS: A total of 120 cases(240 eyes)of myopic children and adolescents treated in the optometry clinic of our hospital from December 2020 to February 2021 were retrospectively selected, and they were divided into the orthokeratology group(60 cases, 120 eyes)and the frame glasses group(60 cases, 120 eyes)according to the myopia correction methods. The changes in ocular surface and meibomian gland after wearing glasses were analyzed, and those changes in patients of different ages were compared between the two groups.RESULTS: Corneal curvature decreased, non-invasive tear film break-up time(NIBUT)shortened and meibomian gland score increased at 3, 6, 9 and 12mo in the orthokeratology group after wearing lens, while lower tear meniscus height increased at 6, 9 and 12mo compared with that before wearing lens. In the frame glasses group, the lower tear meniscus height was higher at 6 and 9mo than that before wearing glasses(both P<0.05). At the same time point, the corneal curvature of the orthokeratology group was significantly lower than that of the frame glasses group at all time points, the NIBUT at 3, 9 and 12mo after wearing the lens was shorter than that of the frame glasses group and the meibomian gland scores were higher at 6, 9 and 12mo than those at the same time point in the glasses group(all P<0.05). After wearing lens for 12mo, the corneal curvature of the orthokeratology group at all ages was significantly lower than that of the frame glasses group, the NIBUT of the orthokeratology group at 8 to 12 years old and 13 to 15 years old was significantly lower than that of the frame glasses group, and the meibomian gland score was significantly higher than that of the frame glasses group(all P<0.05).CONCLUSION: Orthokeratology lens may affect the ocular surface and meibomian glands function, and the effects on ocular surface are more pronounced in children and adolescents under 12 years old. Therefore, younger children and adolescents could be prioritized for myopia correction with framed glasses, and then wearing orthokeratology lens when they get older.