연성콘택트렌즈 착용기간에 따른 눈물막, 각막 및 안구표면의 변화
Changes in Tear Film, Cornea and Ocular Surface According to the Duration of Soft Contact Lens Wear
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목적: 연성콘택트렌즈 착용기간에 따른 눈물막, 각막 및 안구표면의 변화를 알아보고자 하였다. 대상과 방법: 65명 130안을 대상으로 A군(16명 32안)은 연성콘택트렌즈를 착용한 적이 없으며, B군(17명 34안)은 5년 미만, C군(16명32안)은 5년 이상 10년 미만, D군(16명 32안)은 10년 이상 착용한 군으로 전체 대상자를 4군으로 분류하였다. 모든 대상자에게 눈물막파괴시간, 기본눈물분비검사, 각막지각검사, 중심각막두께검사, 안구표면질환지수, 각막표면형광염색검사, 경면현미경검사, 결막압흔세포검사를 시행한 후 A군을 대조군으로 각 군을 비교하였다. 결과: 5년 미만 착용한 B군에서는 눈물막 파괴시간이 의미 있게 감소하였으며 각막표면형광염색 정도와 편평세포 화생정도는 의미있게 증가하였다(p＜0.05). 5년 이상 10년 미만 착용한 C군에서는 안구표면질환지수와 뱀모양염색질이 의미 있게 증가하였고 각막두께와 술잔세포의 밀도는 의미 있게 감소하였다(p＜0.05). 10년 이상 착용한 D군에서는 세포크기 변화율이 의미 있게 증가하였으며각막지각과 육각형세포비율은 의미 있게 감소하였다(p＜0.05). 결론: 연성콘택트렌즈는 착용기간에 따라서 눈물막, 각막 및 안구표면에 의미 있는 변화를 주는 것으로 생각한다.
Abstract
Purpose: The present study evaluated the changes in tear film, cornea and ocular surface according to the duration of soft contact lens wear. Methods: A total 65 patients with 130 eyes were enrolled the present study, and were divided into 4 grous. The control group (group A) was composed of 32 eyes of 16 patients who had not worn soft contact lenses, group B, (34 eyes of 17 patients),had worn soft contact lenses less than 5 years, group C, (32 eyes of 16 patients), had worn soft contact lenses for 5 to 10years and group D, (32 eyes of 16 patients), had worn soft contact lenses for more than 10 years. The tear break-up time (BUT), Schirmer’s test, corneal sensitivity test, central corneal thickness, ocular surface disease index (OSDI), corneal fluorescein staining score, specular microscopy and conjunctival impression cytology were analyzed. The results were compared between the control group and the soft contact lens groups. Results: In group B, BUT significantly decreased, but corneal fluorescein staining score and squamous metaplasia significantly increased (p < 0.05). In group C, OSDI and snake-like chromatin pattern significantly increased, but corneal thickness and goblet cell density significantly decreased (p < 0.05). In group D, the coefficient of variation for endothelium significantly increased,but corneal sensitivity and hexagonality significantly decreased (p < 0.05). Conclusions: Duration of soft contact lens wear influences changes in tear film, cornea and ocular surface.
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