Conjunctival epithelial flap in continuous contact lens wear.
Conjunctival epithelial flap in continuous contact lens wear.
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DOI：
10.1097/opx.0b013e318199d1f7
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发表时间：
2009-04-01
期刊：
影响因子：
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通讯作者：
Lin, Meng C
中科院分区：
文献类型：
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作者：
Graham, Andrew D;Truong, Tan N;Lin, Meng C
目得：结膜上皮瓣（CEF）由从下方结膜分离的细胞片组成，是最近报道的与接触透镜配戴相关的现象，对眼部健康具有潜在后果。虽然CEF通常无症状，但尚不清楚它可能在多大程度上增加不适，炎症反应或感染的长期风险。在这项研究中，我们使用生存分析方法，以获得无偏估计的概率发展CEF，平均生存时间免费的CEF，和年龄，性别，种族，和接触透镜type.METHODS的影响：204名受试者被招募为连续配戴（CW）研究硅水凝胶（SiH）和透气性（GP）接触镜。受试者在整个接触透镜适应期和CW期接受验光师检查。统计方法包括Kaplan-Meier非参数估计的生存函数和考克斯比例风险模型估计的相对影响的协variates.RESULTS：204名受试者，72（35%）开发CEF。在64%的病例中，观察到双侧CEF。大多数病例（90.3%）的CEF出现在上级结膜。GP镜片（94.3天）的平均无CEF生存时间长于SiH镜片（76.5天），SiH镜片发生CEF的概率显著更高（p = 0.002）。虽然有一些证据表明，妇女和非亚洲人保持免费的CEF更长的时间，年龄，性别和种族的影响没有统计学显着。结论：有一个显着增加的风险CEF在受试者戴SiH镜片，与GP镜片相比。配戴SiH镜片的受试者平均保持无CEF的时间较短。需要进一步研究以确定CW中SiH镜片的CEF发生率增加是否会增加眼部不良反应或感染的风险。
PURPOSE: Composed of sheets of cells detached from the underlying conjunctiva, conjunctival epithelial flap (CEF) is a recently reported phenomenon associated with contact lens wear with potential consequences for ocular health. Although CEF is generally asymptomatic, it is not known to what extent it might increase the longer-term risk of discomfort, inflammatory response, or infection. In this study, we use survival analysis methods to obtain unbiased estimates of the probability of developing CEF, the mean survival time free of CEF, and the effects of age, gender, ethnicity, and contact lens type.METHODS: Two hundred four subjects were recruited for a continuous wear (CW) study of silicone hydrogel (SiH) and gas permeable (GP) contact lenses. Subjects were examined by optometrists throughout contact lens adaptation and CW periods. Statistical methods included the Kaplan-Meier nonparametric estimator of the survival function and the Cox proportional hazards model for estimating the relative effects of covariates.RESULTS: Of the 204 subjects, 72 (35%) developed CEF. In 64% of cases, CEFs were observed bilaterally. The majority of cases (90.3%) presented with CEF in the superior conjunctiva. Mean survival time free of CEF was longer for GP lenses (94.3 days) than for SiH lenses (76.5 days), and the probability of developing CEF was significantly greater for SiH lenses (p = 0.002). Although there was some evidence that women and non-Asians remain free of CEF longer, the effects of age, gender, and ethnicity were not statistically significant.CONCLUSIONS: There was a significantly increased risk of CEF in subjects wearing SiH lenses, compared with GP lenses. Subjects wearing SiH lenses remained free of CEF for a shorter time on average. Further study is needed to determine whether the increased incidence of CEF in CW with SiH lenses poses an increased risk of adverse ocular response or infection.