方法：前瞻性研究。选取2025年2月至2025年10月在安徽爱尔眼科医院初次配戴角膜塑形镜的屈光不正患者，采用随机数字表法随机分为试验组使用阳离子纳米乳剂润眼液，对照组使用0.1%透明质酸钠润眼液。两组患者于每日戴镜前、摘镜前各滴用1滴，持续3 mo。比较两组患者戴镜前，戴镜后1 wk，1、3 mo裸眼视力、等效球镜、角膜前表面曲率、泪膜破裂时间、泪膜脂质层评分及角膜荧光素染色评分。

结果：本研究共纳入屈光不正患者64例64眼(均取右眼纳入研究)，最终60例完成随访，试验组30眼(男14例，女16例； 平均年龄9.57±1.07岁)，对照组30眼(男12例，女18例； 平均年龄9.43±1.01岁)。戴镜前后两组患者间裸眼视力、等效球镜、角膜前表面曲率、角膜荧光素染色评分比较均无差异(均P>0.05)，试验组戴镜后各时间点的泪膜破裂时间均显著长于对照组，泪膜脂质层评分均显著优于对照组(均P<0.001)。两组患者戴镜后1 wk，1、3 mo的裸眼视力、等效球镜、角膜前表面曲率均较戴镜前显著改善(均P<0.05)。对照组戴镜后1 wk，1 mo时角膜荧光素染色评分均较戴镜前增加(均P<0.05)，而试验组无显著变化，且两组患者均未出现严重损伤病例。

结论：阳离子纳米乳剂润眼液与0.1%透明质酸钠润眼液在改善角膜塑形镜配戴者视力及角膜形态方面效果相当，但阳离子纳米乳剂润眼液在稳定泪膜、改善泪膜脂质层状态上更具优势，且安全性良好，可作为角膜塑形镜配戴者的理想润眼液选择。

METHODS:A prospective study was conducted on patients with refractive errors who were fitted with orthokeratology lenses for the first time at Anhui Aier Eye Hospital,from February 2025 to October 2025. Patients were randomly assigned to the experimental group, which received a cationic nanoemulsion eye drops, or the control group, which received a 0.1% sodium hyaluronate eye drops. One drop of the assigned lubricant was instilled in each eye before lens insertion and before lens removal in both groups for 3 consecutive months. Uncorrected visual acuity, spherical equivalent, anterior corneal curvature, tear film break-up time, tear film lipid layer score, and corneal fluorescein staining score were compared between the two groups at baseline and at 1 wk, 1 and 3 mo after lens wear.

RESULTS: A total of 64 eyes(all right eyes)from 64 patients with refractive errors were enrolled. Ultimately, 60 patients completed the final follow-up, including 30 in the experimental group(n=30; male/female: 14/16; age: 9.57±1.07 y)and the control group(n=30; male/female: 12/18; age: 9.43±1.01 y). No significant intergroup differences were found in uncorrected visual acuity, spherical equivalent, anterior corneal curvature, or corneal fluorescein staining scores either before or after lens wear(all P>0.05).The tear film break-up time was significantly longer and tear film lipid layer score was significantly better in the experimental group than in the control group at post-wear time point(all P<0.05). Uncorrected visual acuity, spherical equivalent, and anterior corneal curvature improved significantly from baseline at 1 wk, 1 and 3 mo after lens wear in both groups(all P<0.05). Corneal fluorescein staining scores increased significantly from baseline at 1 wk and 1 mo in the control group(both P<0.05), whereas no significant change was observed in the experimental group. No cases of severe corneal injury(score of 3)were found in either group.

CONCLUSION: Cationic nanoemulsion eye drops have a similar effect to 0.1% sodium hyaluronate eye drops in improving the visual acuity and corneal morphology of orthokeratology wearers, but have more advantages in stabilizing the tear film and improving the state of the tear film lipid layer, and have good safety, so they can be used as an ideal choice of eye drops for orthokeratology wearers.