长期配戴角膜塑形镜对青少年视觉质量及细菌感染发生的影响

靳慧霞; 陈霞

doi:10.16835/j.cnki.1000-9817.2022.12.021

长期配戴角膜塑形镜对青少年视觉质量及细菌感染发生的影响

doi: 10.16835/j.cnki.1000-9817.2022.12.021

靳慧霞,
陈霞^,

河南省直第三人民医院眼科，郑州 450053

详细信息

作者简介:
靳慧霞(1981-)，女，河南省人，硕士，主治医师，主要研究方向为眼视光

通讯作者:
陈霞，E-mail：chenxia5260@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R778.3 R446
计量
- 文章访问数: 225
- HTML全文浏览量: 151
- PDF下载量: 126
- 被引次数: 0
出版历程
- 收稿日期: 2022-08-12
- 修回日期: 2022-09-05
- 网络出版日期: 2022-12-30
- 刊出日期: 2022-12-25

Effects of orthokeratology lens on visual quality and bacterial infection in adolescents

JIN Huixia,
CHEN Xia^,

Department of Ophthalmology, Henan No.3 Provincial People's Hospital, Zhengzhou(450053), China

摘要

摘要: 目的探讨青少年长期配戴角膜塑形镜后对视觉质量和细菌感染发生率的影响，为促进青少年用眼卫生提供参考。方法收集前往河南省直第三人民医院定期复查的280例配戴角膜塑形镜的青少年作为研究对象，分别在佩戴前、配戴6个月、配戴1年时间点对患者进行眼部专科检查、视觉质量分析系统(Optical Quality Analysis System Ⅱ, OQAS-Ⅱ)客观视觉质量测评和眼部菌群检查，比较青少年配戴角膜塑形镜前后视觉质量和眼部菌群的变化。结果与配戴角膜塑形镜之前青少年的斯特烈尔比，调制传递函数，9%OV、20%OV、100%OV分别为(0.18±0.04，33.21±4.23，0.72±0.12，0.99±0.19，1.32±0.21)，青少年配戴6个月和配戴1年后患者的斯特烈尔比(0.21±0.05，0.24±0.03)和调制传递函数(37.65±5.29，39.01±3.94)均升高，9%客观视力(0.61±0.10，0.53±0.26)、20%客观视力(0.82±0.21，0.78±0.15)和100%客观视力(1.10±0.13，1.00±0.07)均降低，差异均有统计学意义(F值分别为7.89，6.59，6.52，9.47，8.49，P值均＜0.05)，而客观散射指数配戴前后(0.99±0.21，1.01±0.07，1.23±0.31)差异无统计学意义(F=-1.56，P＞0.05)。与配戴角膜塑形镜前相比，佩戴后患者的细菌感染发生率显著提高(P值均＜0.05)，配戴角膜塑形镜1年的患者铜绿假单胞菌感染率升至0.36%，大肠埃希菌感染率高达0.71%，金黄色葡萄球菌感染率高至0.36%。结论青少年长期配戴角膜塑形镜可有效改善视觉质量，但也会提高细菌感染发生率，需要临床上做好针对青少年的用眼卫生教育。
- 角膜塑形术 /
- 眼镜 /
- 细菌 /
- 感染 /
- 青少年
Abstract: Objective To investigate the effects of orthokeratology on visual quality and incidence of bacterial infection in adolescents. Methods A total of 280 orthokeratology teenage patients were selected. Visual examination, OQAS-Ⅱ optical assessment and ocular flora were assessed before, 6 months and 1-year after orthokeratology wearing. Changes in visual and optical performance and ocular flora infection were compared. Results Compared with before wearing orthokeratography lens (0.18±0.04, 33.21±4.23, 0.72±0.12, 0.99±0.19, 1.32±0.21), parameters of adolescent patients including strayers ratio (0.21±0.05, 0, 24±0.03) and modulation transfer cutoff (37.65±5.29, 39.01±3.94) increased after wearing for 6 months and 1 year, 9% objective visual acuity(0.61±0.10, 0.53±0.26), 20% objective visual acuity (0.82±0.21, 0.78±0.15) and 100% objective visual acuity (1.10±0.13, 1.00±0.07) decreased, the differences were statistically significant (F=7.89, 6.59, 6.52, 9.47, 8.49, P < 0.05), while the objective scattering index index (0.99±0.21, 1.01±0.07, 1.23±0.31) had no significant difference before and after wearing orthokeratography lens (F=-1.56, P>0.05). Compared with before wearing, the incidence of bacterial infection significantly increased after wearing (P < 0.05). The infection rate of pseudomonas aeruginosa in patients who wore orthokeratology lens for 1 year rose to 0.36%, e. coli infection rates as high as 0.71%, staphylococcus aureus infection rates as high as 0.36%. Conclusion Long-term orthokeratology lens wear can effectively improve the visual quality of adolescents, but also increase the risk of bacterial infection. Timely awareness on good eye hygiene practice should be emphasized to the users.
- Orthokeratologic procedures /
- Eyeglasses /
- Bateria /
- Infection /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 配戴角膜塑形镜前后青少年视觉质量比较(x±s，n=280)

Table 1. Comparison of visual quality before and after wearing orthokeratology lens(x±s, n=280)

配戴时间	SR	MTF cutoff/(c·deg^-1)	OSI	9%OV	20%OV	100%OV
配戴前	0.18±0.04	33.21±4.23	0.99±0.21	0.72±0.12	0.99±0.19	1.32±0.21
配戴6月	0.21±0.05	37.65±5.29	1.01±0.07	0.61±0.10	0.82±0.21	1.10±0.13
配戴1年	0.24±0.03	39.01±3.94	1.23±0.31	0.53±0.26	0.78±0.15	1.00±0.07
F值	7.89	6.59	-1.56	6.52	9.47	8.49
P值	0.01	0.02	0.62	0.02	< 0.01	< 0.01

下载: 导出CSV

参考文献(25)

[1]	任美侠, 张国云, 叶璐. 长期配戴角膜塑形镜对患者角膜和视觉质量的影响[J]. 国际眼科杂志, 2022, 22(2): 304-308. https://www.cnki.com.cn/Article/CJFDTOTAL-GJYK202202025.htm REN M X, ZHANG G Y, YE L. Effects of long-term orthokeratology lens on corneal and visual quality of patients[J]. Int J Ophthalmol, 2022, 22(2): 304-308. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GJYK202202025.htm
[2]	吕心印, 陈谕, 胡鑫莉. 角膜塑形镜对不同程度近视患者视觉质量角膜形态及视力状况的影响[J]. 基层医学论坛, 2022, 26(4): 32-34. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLT202204011.htm LYU X Y, CHEN Y, HU X L. Effects of orthokeratology on visual quality and corneal morphology in patients with different degrees of myopia[J]. Med Forum, 2022, 26(4): 32-34. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YXLT202204011.htm
[3]	唐平, 陈春妹, 陈执, 等. 角膜塑形镜对青少年近视的干预效果[J]. 巴楚医学, 2021, 4(4): 81-84. doi: 10.3969/j.issn.2096-6113.2021.04.018 TANG P, CHEN C M, CHEN Z, et al. Effect of orthokeratology lens on adolescent myopia[J]. Bachu Med, 2021, 4(4): 81-84. (in Chinese) doi: 10.3969/j.issn.2096-6113.2021.04.018
[4]	宋峰伟, 孙元强, 杨卫华. 近视性屈光参差患者角膜塑形术后视觉相关生活质量及立体视功能的变化[J]. 中国现代医生, 2021, 59(27): 78-81. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS202127027.htm SONG F W, SUN Y Q, YANG W H. Changes in vision-related QOL and stereoscopic function after orthokera-tology in patients with myopic anisometropia[J]. Chin Mod Doctor, 2021, 59(27): 78-81. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZDYS202127027.htm
[5]	张志辉, 蔡晶晶, 曾胜, 等. 应用夜戴型角膜塑形镜后偏中心情况的研究及其对视觉质量的影响[J]. 中外医学研究, 2021, 19(27): 10-13. https://www.cnki.com.cn/Article/CJFDTOTAL-YJZY202127004.htm ZHANG Z H, CAI J J, ZENG S, et al. The study of off-center condition after night wear orthokeratology lens and its influence on visual quality[J]. Chin Foreign Med Res, 2021, 19(27): 10-13. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YJZY202127004.htm
[6]	田春慧, 雷秀丽, 连丽英, 等. 角膜塑形镜对低中度青少年近视患者对比敏感度的影响[J]. 中国斜视与小儿眼科杂志, 2021, 29(2): 32-34. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXS202102012.htm TIAN C H, LEI X L, LIAN L Y, et al. The effect of orthokeratology on contrast sensitivity of low and moderate adolescent myopia[J]. Chin J Strabismus Pediatr Ophthalmol, 2021, 29(2): 32-34. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXS202102012.htm
[7]	许辉. 角膜塑形镜对青少年近视控制的有效性及双眼视功能影响的观察分析[D]. 青岛: 青岛大学, 2021. XU H. Observation on the efficacy of orthokeratology in myopia control and its influences on binocular function in adolescent population[D]. Qingdao: Qingdao University, 2021. (in Chinese)
[8]	杨成香, 张宏国, 王秀亮. 长期配戴角膜塑形镜治疗青少年近视的效果及并发症[J]. 中国实用医刊, 2021, 48(1): 76-78. YANG C X, ZHANG H G, WANG X L. Effect and complications of wearing orthokeratology lens for a long time in the treatment of juvenile myopia[J]. Chin J Pract Med, 2021, 48(1): 76-78. (in Chinese)
[9]	赵连凯. 角膜塑形镜配戴后偏心对青少年近视患者视觉质量的影响及与并发症的相关性研究[J]. 河北医学, 2020, 26(3): 441-445. https://www.cnki.com.cn/Article/CJFDTOTAL-HCYX202003022.htm ZHAO L K. The influence of orthokeratology lens eccentricity on visual quality of adolescent myopia patients and its correlation with complications[J]. Hebei Med, 2020, 26(3): 441-445. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HCYX202003022.htm
[10]	VINCENT S J, CHO P, CHAN K Y, et al. CLEAR-orthokeratology[J]. Cont Lens Anter Eye, 2021, 44(2): 240-269.
[11]	NTI A N, BERNTSEN D A. Optical changes and visual performance with orthokeratology[J]. Clin Exp Optom, 2020, 103(1): 44-54.
[12]	DUONG K, MCGWIN G J, FRANKLIN Q X, et al. Treating uncomfortable contact lens wear with orthokeratology[J]. Eye Contact Lens, 2021, 47(2): 74-80.
[13]	LEE J H, HONG I H, LEE T Y, et al. Choroidal thickness changes after orthokeratology lens wearing in young adults with myopia[J]. Ophthal Res, 2021, 64(1): 121-127.
[14]	CHEUNG S W, BOOST M V, CHO P. Effect of povidone iodine contact lens disinfecting solution on orthokeratology lens and lens case contamination and organisms in the microbiome of the conjunctiva[J]. Cont Lens Anter Eye, 2021, 44(6): 101412.
[15]	ZHONG Y, KE L, QIONG W, et al. Orthokeratology lens for management of myopia in anisometropic children: a contralateral study[J]. Cont Lens Anter Eye, 2020, 43(1): 40-43.
[16]	尹叶薇, 赵旸, 傅艳燕, 等. 青少年低中度近视患者夜戴角膜塑形镜的临床效果[J]. 中南大学学报(医学版), 2020, 45(8): 966-972. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYD202008016.htm YIN Y W, ZHAO Y, FU Y Y, et al. Clinical results of orthokeratology therapy in adolescents with low to moderate myopia[J]. J Centr South Univ(Med Sci), 2020, 45(8): 966-972. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HNYD202008016.htm
[17]	WU J, XIE H. Orthokeratology lens-related acanthamoeba keratitis: case report and analytical review[J]. J Int Med Res, 2021, 49(3): 675905383.
[18]	唐文婷, 刘娟, 田美, 等. 角膜塑形镜对青少年近视的视觉质量影响研究[J]. 国际眼科杂志, 2019, 19(11): 1931-1935. https://www.cnki.com.cn/Article/CJFDTOTAL-GJYK201911032.htm TANG W T, LIU J, TIAN M, et al. Study on the effect of keratoplasty on the visual quality of myopia in adolescents[J]. Int Eye Sci, 2019, 19(11): 1931-1935. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GJYK201911032.htm
[19]	郑树锋, 李国杰, 杨亚妮, 等. 角膜塑形镜矫治对近视儿童角膜形态及视觉质量的影响[J]. 西部医学, 2019, 31(5): 766-769. https://www.cnki.com.cn/Article/CJFDTOTAL-XIBU201905029.htm ZHENG S F, LI G J, YANG Y N, et al. Impact of orthokeratology lens corrective therapy on corneal surface shape and visual quality of children with myopia[J]. Med J West Chin, 2019, 31(5): 766-769. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XIBU201905029.htm
[20]	王宏娜, 许军. 采用角膜塑形镜进行治疗的青少年近视患者发生角膜塑形镜偏心对其视觉质量的影响[J]. 当代医药论丛, 2019, 17(10): 85-86. https://www.cnki.com.cn/Article/CJFDTOTAL-QYWA201910057.htm WANG H N, XU J. The influence of keratoscopy eccentricity on visual quality of adolescent myopic patients treated with keratoscopy[J]. Contemp Med Forum, 2019, 17(10): 85-86. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-QYWA201910057.htm
[21]	SÁNCHEZ-GARCÍA A, BATRES-VALDERAS L, PIÑERO D P. Orthokeratology with a new contact lens design in hyperopia: a pilot study[J]. Eye Contact Lens, 2020, 46(3): e17-e23.
[22]	周佳. 角膜塑形镜停戴后角膜形态及视觉质量的变化[D]. 天津: 天津医科大学, 2018. ZHOU J. The study of the changes in corneal shape and the optical quality after discontinuation in orthokeratology[D]. Tianjin: Tianjin Medical University, 2018. (in Chinese)
[23]	余文琳. 配戴角膜塑形镜对青少年近视患者泪膜及视觉质量的影响观察[J]. 基层医学论坛, 2018, 22(10): 1349-1350. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLT201810035.htm YU W L. Effect of orthokeratology lens on tear film and visual quality in adolescent myopia patients[J]. Med Forum, 2018, 22(10): 1349-1350. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YXLT201810035.htm
[24]	关大禹, 徐建弟. 角膜塑形镜控制青少年近视的疗效及安全性分析[J]. 甘肃医药, 2018, 37(2): 127-128. GUAN D Y, XU J D. Effect of orthokeratology on myopia in adolescents[J]. Gansu Med J, 2018, 37(2): 127-128. (in Chinese)
[25]	王欢. 角膜塑形镜对眼球生物学和视觉质量影响的研究现状及进展[J]. 中国斜视与小儿眼科杂志, 2017, 25(4): 45-46. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXS201704019.htm WANG H. Research status and progress of the effects of orthokeratology on ocular biology and visual quality[J]. Chin J Strabismus Pediat Ophthalmol, 2017, 25(4): 45-46. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZGXS201704019.htm