圆锥角膜发病的力学因素及其机制

圆锥角膜是一种以角膜进行性变薄前突为特征的角膜扩张性疾病。其发病机制尚不清楚。体外实验表明力学刺激可能通过升高氧化应激水平和炎症因子浓度而损伤角膜基质细胞，造成角膜细胞外基质降解等一系列变化。大量临床研究证实揉眼、由睡姿引起的眼球压迫等力学因素可能在圆锥角膜发生发展的过程中起重要作用。它们可能通过增加泪液炎症因子水平、造成眼压变化、改变角膜生物力学性能以及机械摩擦直接损伤角膜组织、升高角膜上皮温度等机制对角膜造成影响。本文就力学因素对角膜基质细胞、角膜组织的影响及其在圆锥角膜发病机制中可能的作用进行阐述，以期为预防和管理圆锥角膜提供参考。

Mechanical factors and mechanism of keratoconus pathogenesis

Keratoconus is a corneal ectatic disease characterized by progressive corneal thinning and protrusion. Its pathogenesis remains unclear. In vitro experiments have shown that mechanical stimulation may damage corneal stromal cells by increasing oxidative stress level and inflammatory factor concentration, resulting in a series of changes such as degradation of corneal extracellular matrix. Numerous clinical studies have confirmed that mechanical factors, including eye rubbing and eyeball compression caused by sleeping position, may play an important role in the process of keratoconus occurrence and development. They may affect the cornea by increasing the level of inflammatory factors in tear, causing changes in intraocular pressure, changing the biomechanical properties of the cornea, directly damaging corneal tissue by mechanical friction, and increasing the temperature of corneal epithelium. The main aim of this review was to describe the efforts of mechanical factors on corneal stromal cells, corneal tissue, and the possible role of mechanical factors in the pathogenesis of keratoconus, so as to provide a reference for the prevention and management of keratoconus.