【摘要】 目的：研究儿童配戴RGP镜片后角膜敏感性的变化。方法：采用问卷的形式收集基本信息，应用Cochet and Bonnet aesthesiometer测量67例134眼角膜敏感性，按照不同分组进行比较分析。 结果：儿童戴镜1～12mo组，戴镜1～5a组中央部和下方角膜敏感性明显下降（中央P =0.000，下方P ＝0.002），而2组之间的差异无显著意义（中央P ＝0.997，下方P ＝0.056）。儿童戴镜1～5a组颞侧，鼻侧，上方角膜敏感性明显下降（颞侧P ＝0.000，鼻侧P ＝0.000，上方P ＝0.001），戴镜1～5a组与戴镜1～12mo组（颞侧P ＝0.133，鼻侧P ＝0.125,上方P ＝0.205），未戴镜组与戴镜1～12mo组（颞侧P ＝0.06，鼻侧P ＝0.200,上方P ＝0.207），差异均无显著意义。儿童与成年人分别配戴RGP镜片1～12mo和1～5a，中央角膜敏感性无显著差异（1～12mo P＝0.343，1～5a P ＝0.105）。结论：RGP镜片对于儿童和成人的中央角膜敏感性的影响是相似的。但由于儿童自身的特点，为儿童验配RGP仍应慎重。
【关键词】 RGP镜片 角膜敏感性(角膜知觉，CTT)
Effect of RGP contact lens on corneal sensitivity among children
Si-Yi Xu, Li Ma, Fan Lü
1 State College of Optometry, SUNY, 33 West 42nd Street, New York, NY 10036, USA; 2 Zhongshan Medical College, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China; 3 Eye Hospital, Wenzhou Medical College, Wenzhou 325027, Zhejiang Province, China
Abstract AIM: To evaluate corneal sensitivity variation of children after wearing RGP contact lens and to study the relationship between change of corneal sensation and wearing period.METHODS: A total of 67 subjects (134 eyes) were recruited. Questionnaire：age, types of contact lens, wearing periods, daily wearing time, disease associated with change of corneal sensitivity, complaint for wearing contact lens; Slit-lamp biomicroscopy examination: evaluate the fitting, examine cornea, conjunctiva; Corneal sensitivity measurement: measure corneal sensitivity at central, temporal, nasal, superior and inferior corneal location with Cochet and Bonnet aesthesiometer 10 minutes after removing contact lens. Analysis: The subjects were firstly divided into two groups: control group and experimental group. These two groups were further subgrouped on the basis of age, wearing period. The main statistic soft ware SPSS11.0 was used. RESULTS: Variation in corneal sensation of children after wearing RGP lens:(1)central and inferior location: corneal sensitivity significantly decreased within one year wear and one to five years wear（central P＝0.000，inferior P＝0.002）; No significant difference was between these two groups (central P ＝0.997，inferior P＝0.056). (2) nasal, temporal and superior: corneal sensitivity significantly decreased for one to five years wear（temporal P＝0.000，nasal P＝0.000，superior P＝0.001）; wearing contact lens for less than one year just slightly affected corneal sensation ( temporal P＝0.06, nasal P＝0.200, superior P＝0.207. There was no significant difference between children and adult for central corneal sensitivity change after wearing RGP lens（1-12 months P ＝0.343，1-5 years P ＝0.105）. CONCLUSION: RGP lens wear produce a similar type of corneal sensitivity loss for children and adult. Be more careful of fitting RGP for children
· KEYWORDS:corneal sensitivity (corneal sensation , CTT); contact lens (soft lens, RGP lens)
0引言
角膜知觉，即角膜自身对外界物体的感觉，又称为角膜敏感性。研究表明配戴接触镜是影响角膜敏感性的常见因素之一。角膜敏感性的下降虽然会改善接触镜的舒适度，但同时也会对角膜造成严重的损害，因为异物可以长期存留于接触镜后不被感知，角膜疾病的发生率会明显增加，因此，有必要正确评价角膜敏感性，以避免接触镜并发症的发生[1]。另一方面，通过与角膜微囊，角膜水肿，氧通量，内皮细胞多形性这些指标的比较发现，角膜敏感性的测量对于接触镜并发症发生的预测具有很大的价值 [2] 。镜片材料、类型、日戴时间及戴镜历史的长短等因素与角膜敏感性的变化直接相关。目前RGP镜片成为近视儿童验配角膜接触镜的可选择镜片，RGP镜片对儿童角膜敏感性的影响至今未见报道；此外，RGP镜片对于角膜敏感性的影响在过去的研究中尚存在分歧，因此我们将儿童配戴RGP后角膜知觉的改变作为研究重点。
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