AIM: To study the effect of ocular surface and meibomian gland dysfunction of adolescents before and after wearing overnight orthokeratology, and to explore its effects on adolescent tear film.

METHODS: A prospective clinical study was conducted. 55 cases of 8 to 16-year-old adolescents who met the selection criteria from January 2017 to November 2017 were selected for orthokeratology. Before lens wear and after lens wear 1wk, 1mo, 3mo, 6mo, and 12mo were followed up for Ocular Surface Disease Index(OSDI)questionnaire, slit-lamp examination, and Keratograph 5M.

RESULTS: During the study period, no patients developed infectious keratitis. The OSDI scores were 7.38±1.71 points, 9.21±1.39 points, 10.19±1.02 points, 10.28±1.18 points, 10.29±1.85 points after wearing at 1wk, 1, 3, 6, and 12mo respectively, which were higher than those before wearing(4.80±1.63 points)were increased, and the difference was statistically significant at different times before and after wearing(P<0.05). 1wk, 1, 3, 6, 12mo NIBUT(f)values were 12.39±4.76s, 9.95±5.23s, 11.30±4.58s, 11.21±4.34s, 11.63±5.32s, and NIBUT(av)values were respectively 11.26±6.77s, 11.16±6.48s, 13.09±5.79s, 13.13±5.41s, 13.19±5.21s, NIBUT(f)1mo after wearing compared with before wearing, the difference was statistically significant(P<0.05), NIBUT(av)at 1wk and 1mo after wearing was compared with before wearing, the difference was statistically significant(all P<0.05), and the difference was both at 3, 6, 12mo after wearing and before wearing No statistical significance(all P>0.05).There was no significant change in TMH at 1wk, 1, 3, 6, 12mo after wearing, and the difference was not statistically significant(F=2.168, P>0.05). Corneal fluorescein staining scores were 3.51±1.67 points, 3.54±1.62 points, 4.05±1.52 points, 4.14±1.32 points, 4.50±1.43 points, respectively, 1wk after wearing, 1, 3, 6, and 12mo, which were higher than those before wearing(P<0.05). The meibomian gland lipid secretion score and the meibomian gland loss score did not change significantly at different times before and after wearing(P>0.05).

CONCLUSION: The tear film function in the early period of wearing the orthokeratology is reduced, but it gradually returns to the level before wearing the lens after 6mo, and tends to increase steadily. After wearing the orthokerato-scope, the symptoms of eye discomfort increase and corneal fluorescein stain increased after wearing, no effect on meibomian gland function.