配戴角膜矯形鏡(OK鏡)與感染角膜炎的關係

鑒於在2014年,曾有報導指出兒童配戴OK鏡增加5倍患角膜炎的風險,今篇網誌便探討一下該報導是否與事實相符。

香港中文大學報告

報導是源於香港中文大學近年刊登的兩份研究報告。1,2 筆者細閱研究內容,發現研究結果並沒有總結出兒童配戴OK鏡會增加患上角膜炎5倍的說法。一份研究指從2001至2010年,18歲或以下在威爾斯親王醫院 因配戴隱形眼鏡而患上感染性角膜炎的個案有15宗,當中有7宗與配戴OK鏡有關。2 另一研究則指出從2003至2013年,23歲或以下在香港眼科醫院 因配戴隱形眼鏡而患上感染性角膜炎的個案有121宗,當中有23宗與配戴OK鏡有關。1 由此可見,兩份報告只指出配戴OK鏡是有機會引致感染性角膜炎,但增5倍的說法還需有待證實。

美國研究數據

美國近年有研究人員嘗試找出因配戴OK鏡而導致角膜炎的發生率,他們訪問了200名在美國有驗配OK鏡的執業眼科視光師,發現每年10000名18歲或以下的OK鏡配戴者當中,便有14名配戴者患上角膜炎。3 這個發生率與成年人因日間配戴矽水凝膠隱形眼鏡而患上角膜炎的發生率相約 (澳洲有研究指出,每年10000名日間配戴矽水凝膠隱形眼鏡的配戴者當中,便有12名配戴者患上角膜炎4)。雖然這兩個研究的設計方法有所不同,所報告的發生率不能作直接比較,但它們均具有一定的參考作用。家長應權衡角膜矯形術的好處和壞處,從而決定是否進行它。

事實上,配戴任何形式的隱形眼鏡都會增加患角膜炎的風險,只要配戴者找合適專業的眼科視光師,並嚴格跟其建議,定期覆診(OK鏡配戴者最少每隔3-4個月便要檢查一次),感染角膜炎的風險一般都能減到最低。5

註冊眼科視光師(第一部份) 陳家豪


以上護眼資訊由瑞士寶視光中心提供

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參考文獻:

  1. Chan TC, Li EY, Wong VW, Jhanji V. Orthokeratology-associated infectious keratitis in a tertiary care eye hospital in Hong Kong. American journal of ophthalmology 2014.
  2. Young AL, Leung KS, Tsim N, Hui M, Jhanji V. Risk factors, microbiological profile, and treatment outcomes of pediatric microbial keratitis in a tertiary care hospital in Hong Kong. American journal of ophthalmology 2013; 156(5): 1040-4.e2.
  3. Bullimore MA, Sinnott LT, Jones-Jordan LA. The risk of microbial keratitis with overnight corneal reshaping lenses. Optometry and vision science : official publication of the American Academy of Optometry 2013; 90(9): 937-44.
  4. Stapleton F, Keay L, Edwards K, et al. The incidence of contact lens-related microbial keratitis in Australia. Ophthalmology 2008; 115(10): 1655-62.
  5. Cho P, Cheung SW, Mountford J, White P. Good clinical practice in orthokeratology. Contact lens & anterior eye : the journal of the British Contact Lens Association 2008; 31(1): 17-28.
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