目的：探讨3%地夸磷索钠滴眼液在角膜塑形镜早期配戴中对轻度干眼的青少年近视患者眼表和泪液的影响。

方法：前瞻性研究。选取2023年1月至2023年9月于我院初次验配角膜塑形镜的轻度干眼青少年近视患者60例120眼，两组均配戴同一品牌角膜塑形镜，每天配戴时间为8-9 h，每周配戴7 d。随机分为两组：对照组(30例60眼)从验配当日起，采用常规眼睑清洁、热敷的基础治疗方式治疗干眼，观察组(30例60眼)在对照组的基础上使用3%地夸磷索钠滴眼液(每日6次连续点眼3 mo)治疗干眼，停药后随访6 mo。按角膜塑形镜随访要求复查裸眼视力、角膜曲率、角膜地形图、角膜荧光染色。比较两组患者干眼治疗前，治疗1、2、3 mo及停止治疗后3、6 mo眼表疾病指数量表(OSDI)评分、下睑泪河高度(TMH)、首次泪膜破裂时间\〖NIBUT(f)\〗、平均泪膜破裂时间\〖NIBUT(av)\〗、角膜荧光素染色。

结果：所有患者均完成随访。治疗2、3 mo，停药3、6 mo观察组患者NIBUT(f)、NIBUT(av)、下睑TMH均高于对照组(均P<0.05)。两组患者OSDI评分在治疗2 mo较治疗前均显著下降(均P<0.05)。治疗3 mo，停药3、6 mo观察组OSDI评分较对照组显著下降(均P<0.01)。两组患者角膜点染发生率无差异(P=0.731)。

结论：3%地夸磷索钠滴眼液联合眼睑清洁、热敷可有效提高配戴角膜塑形镜早期轻度干眼的青少年近视患者的泪膜稳定性。

METHODS: Prospective study. Totally 60 myopic adolescents(120 eyes)with mild dry eye syndrome who were fitted with orthokeratology lenses for the first time in our hospital from January 2023 to September 2023 were enrolled in this study. They were randomly divided into control group and observation group. Both groups wore the same brand of orthokeratology lenses for 8-9 h a day and 7 d a week. In the control group(30 cases, 60 eyes), the patients were treated by routine eyelid cleaning and warm compresses from the day of fitting. In addition to the control group's treatment, patients in the observation group(30 cases, 60 eyes)were given DQS 6 times a day for 3 mo, and follow-up for 6 mo after discontinuation of DQS. According to the follow-up requirements of orthokeratology lens, uncorrected visual acuity(UCVA), corneal curvature, corneal topography, and corneal fluorescein staining were rechecked. The ocular surface disease index(OSDI)scores, tear meniscus height(TMH)of lower eyelid, non-invasive tear film break-up time \〖first and average, NIBUT(f)and NIBUT(av)\〗 and corneal fluorescein staining were measured at baseline, 1, 2 and 3 mo after treatment, and 3 and 6 mo after DQS discontinuation.

RESULTS: All patients completed follow-up. The NIBUT(f), NIBUT(av)and TMH of lower eyelid in the observation group were higher than those in the control group at 2 and 3 mo after treatment and at 3 and 6 mo after discontinuation of DQ3(all P<0.05). The OSDI scores for both groups decreased significantly at 2 mo after treatment(all P<0.05). At 3 mo after treatment and 3 and 6 mo after discontinuation of DQS, the OSDI scores in the observation group was significantly lower than the control group(all P<0.01). There was no significant difference of corneal fluorescein staining between the two groups(P=0.731).

CONCLUSION: The combination of DQS with eyelid hygiene and warm compresses shows better efficacy in enhancing the stability of the tear film for adolescents with mild dry eye syndrome while wearing orthokeratology lenses.