目的：观察配戴角膜塑形镜后的泪液渗透压及炎症因子水平变化。

方法：前瞻性随机对照试验。纳入2016-05/2019-02就诊的-1.00～-5.00D的79例青少年近视患者，随机分为角膜塑形镜组39例配戴角膜塑形镜及框架眼镜组40例配戴框架眼镜。随访观察患者治疗1a期间的平均非侵入性泪膜破裂时间(NIKBUTav)、泪液渗透压(TFO)、泪液白介素-1β(IL-1β)、白介素-6(IL-6)和肿瘤坏死因子α(TNFα)表达。

结果：角膜塑形镜组NIKBUTav及泪液TNFα戴镜6mo，1a、停戴后4wk与戴镜前有差异(P<0.001)； TFO戴镜1、3、6mo，1a与戴镜前有差异(P<0.001)； 泪液IL-1β及泪液IL-6戴镜3、6mo，1a与戴镜前有差异(P<0.001)。戴镜1a角膜塑形镜组NIKBUTav(8.54±1.92s)低于框架眼镜组(12.93±2.22s)(P<0.001)，角膜塑形镜组TFO、IL-6、TNFα均高于框架眼镜组(P<0.01)； 而IL-1β角膜塑形镜组(16.60±4.32ng/mL)和框架眼镜组(14.67±4.43ng/mL)无差异(P=0.053)。

结论：配戴角膜塑形镜后，NIKBUTav降低，TFO、IL-1β、IL-6、TNFα升高，但具有可逆性。

METHODS: Prospective randomized controlled trial. Totally 79 cases of adolescent myopia(-1.00D to -5.00D)were selected from May 2016 to February 2019. Then they were randomly divided into the experimental group(39 cases)and the control group(40 cases). The experimental group wore orthokeratology lens, and the control group wore frame glasses. Their average noninvasive Keratograph tear breakup time(NIKBUTav), TFO, concentrations of IL-1β, IL-6, TNFα in tear samples were observed for 1a.

RESULTS: NIKBUTav and TNFα after wearing orthokeratology lens for 6mo, 1a and stopping wearing for 4wk were different from that pre-wearing orthokeratology lens(P<0.001). TFO after wearing orthokeratology lens for 1, 3, 6, 12mo were different from that pre-wearing orthokeratology lens(P<0.001). IL-1β and IL-6 in tears after wearing orthokeratology lens for 3, 6, 1a were different from that pre-wearing orthokeratology lens(P<0.001). One year later, NIKBUTav of orthokeratology group(8.54±1.92s)was lower than that of glasses group(12.93±2.22s)(P<0.001). The levels of TFO, IL-6 and TNFα in the orthokeratology group were higher than those in the glasses group(P<0.01). However, there was no difference in IL-1β between the orthokeratology group(16.60±4.32ng/mL)and the glasses group(14.67±4.43ng/mL)(P=0.053).

CONCLUSION After wearing orthokeratology lens, NIKBUTav decreased, and TFO, IL-1β, IL-6, TNFα increased, but they were reversible.