| Purpose To investigate the short-term influence of orthokeratology treatment on the ocular surface and tear film,and to study the effects of orthokeratology treatment on conjunctive cells in myopic adolescents.Methods In the first part,65 subjects wearing orthokeratology lenses were included in the prospective study.The subjects aged from 9 to 16 years(12.11 ± 2.51 years old),with mean spherical equivalent refraction-2.75 ± 1.49 D at baseline.The ocular surface disease index(OSDI),the meniscus height(TMH),first noninvasive tear film breakup time(NITBUT-f),meibomian gland examination,corneal topography,uncorrected visual acuity and slit-lamp evaluation and were measured at baseline and at l week,1 month,3 months and 6 months after orthokeratology treatment.In our study,the MATLAB program were used to calculate the best fitting circle.With the circle,the cornea was divided into TZ and PTZ.In the second part,the cross-sectional study included three groups: the control group(15 cases),T1 group with less than 5 years(19 cases)and T2 group with more than 5 years(15 cases).Epithelial cell morphology and goblet cell density of the conjunctival surface were evaluated by conjunctival impression cytology(CIC).Results Compared with the baseline value,the OSDI scores and TMH kept stable(P > 0.05).The NITBUT-f decreased slightly after single night wear(P > 0.05).It significantly decreased at 1 week,1 month,3 months,6 months after wearing orthokeratology lenses(P < 0.05).Furthermore,the research found that the NITBUT-f in the TZ exhibited a decreased at 1 week,1 month,3 months after wearing orthokeratology lenses,and rose to the level of 1 day at 6 months.No significant changes were detected in NITBUT-f of PTZ after orthokeratology use.During baseline,the occurrence of first tear film break-up points was located in the nasal cornea,closely followed by the inferior and temporal quadrants.After 1 week,1 month,3 months,6 months of orthokeratology treatment,the first tear film breakup points were still located in nasal cornea,while the occurrence of first tear film breakup points in the central cornea increased.The meibomian gland loss scores kept steady at 1 day and 1 week after orthokeratology treatment,with the mean score was 1.63 ± 0.92.The meibomian gland loss scores increased slightly at 1 month,3 months,6 months after wearing orthokeratology lenses(P>0.05).Wearing orthokeratology lenses for a long time had an effect on GCD,the GCD of T1 group and T2 group were lower than that of normal control group(P>0.05).The CIC grades in normal control group were concentrated in grade 0 and grade 1.There existed CIC grades 0-3 in T1 group,but mainly in grade 1.The CIC grades in T2 group were mainly concentrated in grade 1 and grade 2.Conclusion The OSDI scores,TMH and meibomian gland loss scores kept stable within the orthokeratology treatment period in myopic adolescents.The tear film stability decreased,which was manifested by NITBUT-f shorten and the frequency of first tear film breakup points in the central cornea increased.The decrease of tear film stability mainly occurred at 1 week after wearing lenses,which may be related to the change of the anterior corneal surface topography.Wearing of orthokeratology lenses had an effects on GCD and squamous metaplasia of conjunctival epithelial cells. |
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