摘要目的:评价舒润液、不含防腐剂的玻璃酸钠滴眼液和质量分数0.9%生理盐水对角膜塑形镜配戴患者眼表和近视疗效的影响。方法:采用对检查者单独设盲的随机对照研究，纳入2017年6月至2018年4月在海南省眼科医院接受正规角膜塑形镜验配的近视患者90例90眼，均取右眼数据进行分析，按照随机数字表法随机分为玻璃酸钠组、舒润液组及生理盐水组，每组各30例，分别使用不含防腐剂的1 g/L玻璃酸钠滴眼液、舒润液和9 g/L不含防腐剂的生理盐水摘戴眼镜。分别于戴镜前和戴镜后1 d、1周、1个月、3个月进行裸眼视力、等效球镜、角膜地形图、非侵入首次泪膜破裂时间(NIKf-BUT)以及角膜上皮荧光素染色(FL)检测。结果:玻璃酸钠组戴镜后1 d、1周、1个月、3个月的NIKf-BUT分别为(7.13±1.71)、(6.61±1.49)、(6.37±1.82)和(7.01±1.63)s，舒润液组分别为(6.32±1.71)、(5.53±1.42)、(5.57±1.50)和(6.17±1.63)s，生理盐水组分别为(6.36±1.58)、(5.81±1.49)、(5.74±1.77)和(6.28±1.53)s；戴镜后各时间点玻璃酸钠组NIKf-BUT均高于舒润液组和生理盐水组，差异均有统计学意义(均 P<0.05)，舒润液组和生理盐水组各时间点NIKf-BUT比较，差异均无统计学意义(均 P>0.05)。玻璃酸钠组戴镜后各时间点FL评分均低于舒润液组和生理盐水组，差异均有统计学意义(均 P<0.05)，生理盐水组和舒润液组戴镜后各时间点FL评分比较，差异均无统计学意义(均 P>0.05)。3个组间戴镜后各时间点的裸眼视力、等效球镜度和平均角膜前表面曲率K值比较，差异均无统计学意义(均 P>0.05)。 结论:相较于舒润液和生理盐水，不含防腐剂的1 g/L玻璃酸钠滴眼液在角膜塑形镜配戴早期可以更好地稳定泪膜，对角膜上皮的影响更小，但在视力提高和角膜塑形的速度上无明显差别。

abstractsObjective:To compare the difference of the ocular surface and efficacy of orthokeratology lenses wearing after using sodium hyaluronate eye drops, rewetting drops and saline solution.Methods:A randomized single-blind controlled trial was conducted.A total of 90 right eyes from 90 myopic patients were recruited from June 2017 to April 2018 in Hainan Eye Hospital.All the subjects received vision correction by orthokeratology lens, and were randomly divided into three groups by random number table method, with 30 eyes in each group.The sodium hyaluronate group was given preservative-free sodium hyaluronate eye drops (1 g/L), the rewetting drops group was given rewetting drops, and the saline solution group was given nonpreserved 0.9% NaCl.The vision, subjective refraction, corneal topography, non-invasive first tear film break-up time(NIKf-BUT) and fluorescein stain of corneal epithelium (FL) were detected before and 1 day, 1 week, 1 month, 3 months after the lens wearing.This study adhered to the Declaration of Helsinki and was approved by the institutional Ethical Committee Review Board of Hainan Eye Hospital.Results:The NIKf-BUT in the sodium hyaluronate group at 1 day, 1 week, 1 month and 3 months after wearing orthokeratology lens was (7.13±1.71), (6.61±1.49), (6.37±1.82) and (7.01±1.63) seconds, respectively, which was obviously higher than (6.32±1.71), (5.53±1.42), (5.57±1.50) and (6.17±1.63) seconds in the rewetting drops group at the corresponding time points and (6.36±1.58), (5.81±1.49), (5.74±1.77) and (6.28±1.53) seconds in the saline solution group at the corresponding time points (all at P<0.05). There was no statistically significant difference in FL score between the rewetting drops group and saline solution group at 1 day, 1 week, 1 month and 3 months after wearing the orthokeratology lens (all at P>0.05). Lower FL scores were observed in the sodium hyaluronate group compared to the the rewetting drops group and saline solution group after wearing the orthokeratology lens (all at P<0.05). No differences were found in uncorrected visual acuity, spherical equivalent and average K value among the groups (all at P>0.05). Conclusions:Compared with the rewetting drops and saline solution, the preservative-free sodium hyaluronate eye drops can stabilize the tear film and have less effect on corneal epithelium at the early stage of orthokeratology lens wearing.However, there is no significant difference in the improvement of visual acuity and the rate of corneal shaping.