[Analysis of corneal complications in children wearing orthokeratology lenses at night].

Objective: To explore the characteristics, prognoses and corneal complications of children wearing orthokeratology lenses (Ortho-K) at night. Methods: Retrospective case analysis. A total of 113 cases (219 eyes) wore Ortho-K for myopia at night, including 7 cases with unilateral glass wear. The average age was (11.5±2.0) years old. The myopia ranged from -1.00 D to -9.00 D in all eyes and from -2.00 D to -4.00 D in 157 of them. Examinations were performed before lens wearing, at 1 hour, the next morning, 2 days, 3 days, 1 week and 2 weeks after lens wearing, and thereafter once a month. The follow-up was 6 months. Slit lamp examination was used to observe whether there was edema, mechanical damage, pigment deposition, turbidity or infiltration. The morphology, location, number, range and depth of fluorescein staining were tracked for more than 6 months. Results: There were punctate corneal epithelial exfoliation in 18 cases (29 eyes, 13.24%), corneal stromal infiltration and opacity in 5 cases (6 eyes, 2.74%), and corneal iron deposition in 9 cases (17 eyes, 7.76%), with no obvious symptoms. After stopping wearing lenses and related treatment, the punctate epithelial exfoliation was completely cured, and the other complications gradually disappeared within 6 months. These complications occurred within 3 months after lens wearing in six eyes and after at least 6 months of lens wearing in 46 eyes. Conclusions: Children who have complications after wearing Ortho-K at night should immediately stop wearing the lenses. Timely treatment and follow-up help to avoid deterioration and serious complications. Orthokeratology should be performed in medical institutions, with the follow-up by qualified ophthalmic doctors. (Chin J Ophthalmol, 2017, 53:198-202).目的： 探讨儿童夜戴角膜塑形镜角膜并发症的特点、原因及转归。 方法： 回顾性病例分析。收集夜戴角膜塑形镜治疗近视113例（219只眼），其中7例患者为单眼戴镜，平均年龄（11.5± 2.0）岁，近视度数-1.00～-9.00 D，其中-2.00～-4.00 D 157只眼，于配戴角膜塑形镜当日，戴镜后1h、次日早晨及戴镜后2 d、3 d、1周、2周进行检查，之后每月复查1次，随访6个月。裂隙灯检查法观察角膜是否有水肿、机械损伤、色素沉积、混浊浸润；对荧光素染色形态、位置、数量、范围、深度追踪6个月以上。 结果： 点状角膜上皮剥脱18例（29只眼，13.24%），角膜浅基质层浸润混浊5例（6只眼，2.74%），角膜上皮下铁沉积症9例（17只眼，7.76%），以上均无明显症状，经停戴镜及相关治疗，前者完全治愈，但后两者经6个月随访，病灶渐退。上述并发症除6只眼在3个月内出现，其余46只眼均发生在戴镜6个月以上。 结论： 儿童夜戴角膜塑形镜出现并发症应立即停戴镜，及时治疗和随访，避免恶化或出现严重并发症。角膜塑形术应严格控制在医疗单位进行，并由有资质的眼科医师随诊。（中华眼科杂志，2017，53：198-202）.