Objective

To investigate the effect of overnight orthokeratology (OOK) on the ocular surface and dry eye-related cytokines in children.

Methods

A non-randomized, prospective pilot study was conducted including sixty myopes treated with OOK and sixty age-matched spectacle wearing participants. The following tests were performed before and after 1, 3, 6 and 12 months: ocular surface disease index (OSDI), noninvasive tear breakup time (NITBUT), tear meniscus height (TMH), corneal fluorescein staining (CFS), meiboscore using noncontact meibography. Then the concentrations of interleukin-17A (IL-17A), interleukin-6 (IL-6), and prostaglandin E2 (PGE2) in tear samples were detected with a multiplex immunobead assay at different time points.

Results

All parameters had no statistical differences between the two groups prior to treatment. No adverse events were observed except trace to moderate corneal staining and allergic conjunctivitis in the treatment group. NITBUT significantly decreased after 6 and 12 months OOK wearing (P = 0.003 and P = 0.001, respectively). After wearing OOK there was a significant increase in CFS at each follow-up time point compared with baseline (P = 0.023, P = 0.016, P = 0.001, and P < 0.001at 1, 3, 6, and 12 months, respectively). The upper meiboscore and the total meiboscore increased gradually and peaked at 12 months of OOK (both P < 0.001). The concentration of the three cytokines in the treatment group significantly increased after OOK wearing. These increases occurred at different time points: IL-17A increased significantly 3 months after OOK, IL-6 at 6 months, and PGE2 at 12 months (all P < 0.001). However, there were no significant changes in the above parameters in the control group. There were no significant differences in the OSDI or TMH at any follow-up time point compared to baseline in both groups (both P > 0.05).

Conclusions

Short-term OOK may reduce the stability of the tear film and increase damage to the corneal epithelium. Long-term OOK could induce ocular inflammation through the disruption of meibomian glands.

中文翻译：

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夜间角膜塑形术对儿童眼表和干眼相关细胞因子 IL-17A、IL-6 和 PGE2 的影响。

客观的

研究夜间角膜塑形术 (OOK) 对儿童眼表和干眼相关细胞因子的影响。

方法

进行了一项非随机、前瞻性的试点研究，其中包括 60 名接受 OOK 治疗的近视患者和 60 名年龄匹配的佩戴眼镜的参与者。在 1、3、6 和 12 个月之前和之后进行了以下测试：眼表疾病指数 (OSDI)、无创泪膜破裂时间 (NITBUT)、泪液半月板高度 (TMH)、角膜荧光素染色 (CFS)、使用非接触式的meiboscore微博。然后在不同时间点用多重免疫珠法检测泪液样本中白细胞介素-17A（IL-17A）、白细胞介素-6（IL-6）和前列腺素E2（PGE2）的浓度。

结果

治疗前两组所有参数均无统计学差异。治疗组除微量至中度角膜染色和过敏性结膜炎外，未观察到不良事件。在佩戴 OOK 6 个月和 12 个月后，NITBUT 显着降低（分别为 P = 0.003 和 P = 0.001）。佩戴 OOK 后，与基线相比，每个随访时间点的 CFS 均显着增加（分别在 1、3、6 和 12 个月时 P = 0.023、P = 0.016、P = 0.001 和 P < 0.001） . 上meiboscore和总meiboscore逐渐增加并在OOK的12个月达到峰值（均P <0.001）。OOK佩戴后，治疗组三种细胞因子的浓度显着升高。这些增加发生在不同的时间点：OOK 后 3 个月 IL-17A 显着增加，6 个月时的 IL-6 和 12 个月时的 PGE2（所有 P < 0.001）。但对照组上述参数无明显变化。与基线相比，两组在任何随访时间点的 OSDI 或 TMH 均无显着差异（均 P > 0.05）。

结论

短期OOK可能会降低泪膜的稳定性，增加对角膜上皮的损伤。长期 OOK 可通过破坏睑板腺引起眼部炎症。