近视青少年佩戴角膜接触镜的横断面调查研究

doi:10.3760/cma.j.issn.1007-1245.2023.06.014

摘要/Abstract

摘要：

目的　调查近视青少年佩戴角膜接触镜（CL）的现况、规范性及健康素养。方法　选取2022年3月至2022年7月在济南市第二人民医院眼科门诊佩戴CL的近视青少年开展横断面调查研究，共向604例佩戴CL近视青少年发放问卷，561例近视青少年纳入分析，其中男156例、女405例，年龄14～25岁，根据成年年龄，划分为14～17岁组（133例）与18～25岁组（428例）。分别采用济南市第二人民医院眼科医护团队设计的量表调查近视青少年佩戴CL现况、规范性及健康素养。统计学方法采用χ²检验、t检验。结果　两组近视青少年目前佩戴的CL来源、CL种类、CL保质期、过去6个月平均每周佩戴时间、佩备框架眼镜方面比较，差异均有统计学意义（χ²=13.220、34.769、11.065、49.498、7.710，均P<0.05）。18～25岁近视青少年CL来源于非专业机构比例、框架眼镜比例、软性接触镜比例均高于14～17岁近视青少年［（67.99%（291/428）比60.15%（80/133）、94.39%（404/428）比87.22%（116/133）、64.02%（274/428）比40.60%（54/133）］。近视青少年在佩戴CL前检查镜片是否存在污染或沉淀物、取戴CL时首先清洁双手、每次清洁镜片会在镜片双面采用专用清洗液摩擦镜片方面正确率最高，分别为96.26%（540/561）、93.05%（522/561）、78.97%（443/561）。18～25岁近视青少年在按照建议时间佩戴、佩戴CL前检查镜片是否存在污染或沉淀物、浸泡时间超过4 h及每周彻底清洁1次CL，并风干CL佩戴规范行为均高于14～17岁组［71.26%（305/428）比57.14%（76/133）、97.89%（419/428）比90.98%（121/133）、64.49%（276/428）比53.38%（71/133）、70.79%（303/428）比49.62%（66/133）］，差异均有统计学意义（χ²=9.282、13.484、5.301、20.202，均P<0.05）。佩戴CL健康素养：77.90%（437/561）同意长期佩戴CL可引起角膜缺氧、易诱发角膜上皮损伤；74.69%（419/561）同意CL可增加角膜炎、结膜炎风险；80.04%（449/561）同意CL引起视疲劳，甚至干眼症；89.84%（504/561）同意延长CL佩戴时间有害；79.32%（460/561）同意超出CL保质期佩戴有害。结论　本研究中近视青少年佩戴CL种类以软性接触镜为主，CL来源于网上购物等非专业机构比例较高，近视青少年整体规范佩戴CL行为有继续提升的空间。近视青少年多认可CL可能带来的潜在危害，眼科医护人员、CL制造商及CL从业者应更好的教育患者，以促进镜片的规范使用，并关注佩戴CL期间出现不适症状的正确处理与眼科检查问题。

关键词:

近视, 角膜接触镜, 现状调查, 横断面, 青少年

Abstract:

Objective　To investigate the current status, normality, and health literacy of myopic adolescents wearing corneal contact lenses (CL). Methods　A cross-sectional study was conducted on the myopic adolescents wearing CL in Eye Clinic, Jinan Second People's Hospital from March 2022 to July 2022. Six hundred and four questionnaires were handed out to the adolescents, and 561 ones were included for the analysis, including 156 cases and 405 cases; they were 14-25 years old; according to their age, the were divided into a 14-17 years old group (133 cases) and an 18-25 years old group (428 cases). The scale designed by our ophthalmology team was used to investigate their current status, normality, and health literacy. χ² and t tests were applied. Results　There were statistical differences in the CL source, CL type, CL expiration date, average wearing time per week in the past six months, and wearing spectacles between these two groups (χ²=13.220, 34.769, 11.065, 49.498, and 7.710; all P<0.05). The proportions of the myopic adolescents who purchased CL from non-professional institutions, wore spectacles, and had soft contact lenses in the 18-25 years old group were higher than those in the 14-17 years old group [(67.99% (291/428) vs. 60.15% (80/133), 94.39% (404/428) vs. 87.22% (116/133), and 64.02% (274/428) vs. 40.60% (54/133)]. The accurate rates of that the adolescents checked whether there was pollutant or precipitate on the lenses before they put on the CL, washing hands before putting on or taking off the CL, and rubbing both sides of the lenses each time they cleaned them were the highest, and were 96.26% (540/561), 93.05% (522/561), and 78.97% (443/561), respectively. The proportions of the myopic adolescents who wore them at the recommended time, who checked lenses for contamination or deposits before wearing CL, who soaked the CL for more than 4 h, and who cleaned CL thoroughly once a week and air dried them in the 18-25 years old group were higher than those in the 14-17 years old group [71.26% (305/428) vs. 57.14%(76/133), 97.89% (419/428) vs. 90.98% (121/133), 64.49% (276/428) vs. 53.38%(71/133), and 70.79%(303/428) vs. 49.62% (66/133)], with statistical differences (χ²=9.282, 13.484, 5.301, and 20.202; all P<0.05). Health literacy of wearing CL: 77.90% (437/561) agreed that long-term wearing of CL could cause corneal hypoxia and induce epithelial damage; 74.69% (419/561) agreed that CL could increase the risk of keratitis and conjunctivitis; 80.04% (449/561) agreed that CL could cause visual fatigue and even dry eyes; 89.84% (504/561) agreed that prolonged wearing time was harmful; 79.32% (460/561) agreed that wearing CL beyond the shelf life was harmful. Conclusions　The types of CL worn by myopic adolescents in this group were mainly soft contact lenses, and the proportion of CL from non-professional institutions such as online shopping was high; the overall standardized wearing behaviors of the myopic adolescents had room for further improvement; myopic adolescents mostly recognized the potential hazards that CL might bring. Ophthalmologists, CL manufacturers, and CL practitioners should better educate patients to promote the standardized use of lenses, and need to pay attention to the proper management of discomfort and eye examinations during CL wearing.

Key words:

Myopia , wearing, Corneal contact lenses, Current status, Cross section, Adolescents

吴敏于娜王凌云薛凌黄烁傅特.

近视青少年佩戴角膜接触镜的横断面调查研究 [J]. 国际医药卫生导报, 2023, 29(6): 807-813.

Wu Min, Yu Na, Wang Lingyun, Xue Ling, Huang Shuo, Fu Te.

A cross-sectional survey study on myopic adolescents wearing corneal contact lenses [J]. International Medicine and Health Guidance News, 2023, 29(6): 807-813.

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