| Research BasicsStudies show that the myopia rate of children in China is gradually increasing.Because the mechanism of myopia has not been clarified,there is still no effective treatment method.Atropine,orkeratoplasty,peripheral defocused contact lens and so on are used to control the growth of myopia.With the development of high permeability contact lens materials,it is possible to use contact lenses during sleep.The clinical efficacy of night wear corneal plastic lens in correcting myopia has been established.A large number of studies have also confirmed the effectiveness of 0.01%atropine eye drops in myopia control.With the development of the study,it has found that 0.01%atropine combined with corneal plastic lens can control the progression of myopia better than the two alone.Previous studies have found that 0.01%atropine has adverse reactions,the use of corneal plastic lens will affect the ocular surface status,but there is a lack of research on the combined use of both to control the progress of myopia on ocular surface symptoms and signs.To explore the safety of the treatment for myopia.ObjectiveBy observing the effect of 0.01%atropine eye drops combined with corneal plastic lens on ocular surface symptoms and signs,it provides clinical basis for timely detection of possible ocular surface problems in the process of myopia control.MathodsThis is a prospective,randomized,double-blind,controlled study.From March 2020 to August 2020,best corrected visual acuity(BCVA),corneal Fluorescein staining,slit lamp,anterior chamber depth,corneal curvature,axial length and corneal topography and the ocular surface disease index(OSDI)were examined in 380 children aged from 8 to 12 with Myopia equivalent spherical diopter of-1.00 d to-4.00 D and astigmatism ≤-1.50 D in The ophthalmic clinic of the First Affiliated Hospital of Zhengzhou University,the Tear River Height(TMH),First non-invasive tear film break-up time(NIKBUTf),Average non-invasive tear film break-up time(NIKBUTav),lipid layer(LG),meibomian gland evaluation(MGE),ocular red index(HI)and eyelid gland opening were examined by Oculus Keratograph 5M.Sixty-four patients who met the inclusion criteria were included in the study.They were randomly divided into the combined group and the control group according to 1:1 random number table method.In the combined group,2 cases were lost,1 case was removed due to lens loss,2 cases were lost in the control group,1 case was removed due to irregular eye-pointing,29 cases in each group were included in the study.In the combined group,29 patients(29 eyes)wore Orthokeratology alone for 2 months,followed by 0.01%atropine eye drops every night starting from the third month,followed by Orthokeratology 10 minutes later.In the control group,29 patients(29 eyes)wore Orthokeratology alone for 2 months,and after 3 months,they were treated with a blank menstruum eyedrop every night.After 10 minutes,they were treated with Orthokeratology eyedrops.All patients were kept wearing glasses for at least 8 hours every night.Before wearing glasses,1 day,7 days,2 months,5 months follow-up inspection,collecting and sorting out data,the changes of ocular surface symptoms and signs were observed when 0.01%atropine eye drops combined with Orthokeratology were used to control the progression of Myopia in children.Results1.Two groups of wearing glasses on the 1 day,7 days the OSDI score was higher than before wearing glasses and wearing glasses for 2 months,5 months,the difference was statistically significant(P<0.05),wearing glasses for 2 months OSDI the score returned to the level before wearing glasses.There was no significant difference in OSDI score between the two groups after treatment(P>0.05),there was a difference between different time(P<0.05),and there was no interaction between different treatment methods and time(P>0.05).There was no significant difference in OSDI score between the two groups before and after wearing glasses(P>0.05).2.The NIKBUTf of each time point after wearing the mirror in the two groups was less than the baseline value,and the difference was statistically significant on the 1 and 7 days of wearing the mirror There was no significant difference in NIKBUTf between the two groups after treatment(P>0.05),and the difference between NIKBUTf at different time points was statistically significant(P<0.05).There was no significant difference NIKBUTf time points before and after wearing glasses(P>0.05).3.The NIKBUTav of each time point of the two groups was less than the baseline value,and the difference was statistically significant at 1 day and 7 days(P<0.05).There was no significant difference in NIKBUTav between the two groups after treatment(P>0.05),and the difference between NIKBUTav at different time points was statistically significant(P<0.05).There was no significant difference NIKBUTav time points before and after wearing glasses(P>0.05).4.There was no significant difference in TMH、LLG、MGE、tarsal gland opening score,HI、corneal fluorescein staining score and premirror examination score between the two groups(P>0.05).There was no significant difference in TMH、LLG、MGE、tarsal gland opening score,HI score and corneal fluorescein staining score between the two groups after treatment(P>0.05).There was no significant difference in tarsal gland opening score,HI score and corneal fluorescein staining score at different time points(P>0.05).There was no significant difference between the two groups in TMH、LLG、MGE、tarsal gland opening score and HI、corneal fluorescein staining score at each time point before and after wearing glasses(P>0.05).Conclusions1.0.01%atropine eye drops combined with orkeratoplasty to control myopia progression in children is relatively safe for the ocular surface and does not cause changes in tear river height,lipid layer,tarsal gland function,tarsal gland opening,eosin,corneal fluorescein bisection.2.The early wearing of OK lens can slightly increase the index of ocular surface disease(OSDI)and reduce the stability of tear film. |
PDF Full Text Request