目的：观察夜戴型角膜塑形镜矫正青少年近视对眼表和泪膜的影响及眼表不适症状。

方法：前瞻性研究。选取12～18岁近视患者69例138眼，其中使用框架眼镜者31例，使用角膜塑形镜者38例。分别于戴镜1、3、6、12mo时进行眼表疾病指数(OSDI)和眼表染色评分(Oxford法)，检测泪膜破裂时间(TBUT)、非接触性泪膜破裂时间(NIBUT)及基础泪液分泌量。

结果：与框架眼镜组和戴镜前比较，戴镜后各时间点角膜塑形镜组患者OSDI评分升高，TBUT和NIBUT均降低，且戴镜6、12mo时角膜塑型镜组患者眼表染色评分均高于框架眼镜组(均P<0.05)，但戴镜前后两组患者基础泪液分泌量无明显差异(P>0.05)。

结论：角膜塑形镜会导致OSDI和眼表染色评分轻度升高，影响泪膜稳定性，应加强眼表和泪膜情况的戴镜前检查和随访，重视患者的不适主诉。

METHODS: This is a prospective study included 69 myopic adolescents(138 eyes)aged 12-18 years old. 31 subjects were fitted with spectacles and 38 underwent OK treatment for 12mo. All subjects were measured with the ocular surface disease index(OSDI), the corneal and conjunctival fluorescein staining(the Oxford Scheme), tear film breakup time(TBUT), noninvasive tear break-up time(NIBUT)and the Schirmer I test before wearing and at 1, 3, 6, and 12mo after wearing.

RESULTS: Compared with the spectacle group and baseline, the OSDI scores were significantly higher at all recording time, the Oxford scores were significantly higher at 6 and 12mo, and TBUT and NIBUT were significantly lower at all recording time in the OK group(all P<0.05). Conversely, no statistically differences were observed in the Schirmer I test comparing the two groups(P>0.05)while no statistically differences were observed in the Schirmer I test comparing the two groups(P>0.05).

CONCLUSION: OK wearing may increase the OSDI and the Oxford scores mildly, and decrease the stability of tear film. Special attention must be paid to the OK wearers with baseline and follow-up ocular surface, tear film condition, and discomfort symptoms.