PRK术后应用亲水性软性角膜接触镜的临床观察

Clinical observation of therapeutic soft contact lenses after PRK

目的 观察亲水性软性角膜接触镜在准分子激光屈光性角膜切削术 (PRK)后的临床效果。 方法 将双眼屈光状态基本相同,屈光度为-1 00^-6 00D,进行近视PRK矫正的患者 148例,分为术后戴角膜接触镜 3d与不戴两组。观察记录术后 3d的角膜上皮愈合情况、疼痛程度、角膜上皮下混浊程度。术后平均随访半年。 结果 戴镜组术后2d内角膜上皮完全愈合率为 68%,对照组为 24% (P<0 05 )。戴镜组疼痛 0 5级、1级、2级的发生率分别为 58%、20%、22%,对照组为 0、54%、45% (P<0 05)。戴镜组术后 1、3、6个月的角膜haze发生率分别为 50%、32%、14%,对照组为 83%、70%、35% (P<0 05)。 结论 亲水性软性角膜接触镜可明显减轻PRK术后疼痛等刺激症状,促进角膜上皮愈合,使角膜haze发生减少和程度减轻,表明PRK术后角膜创面覆盖及上皮快速愈合是减轻haze发生的重要条件之一。

Objective To observe and evaluate the effect of therapeutic soft contact lenses following photorefractive keratectomy (PRK). Methods 148 cases with diopter of -1 00 to -6 00 D and almost identical refractive ability in both eyes were divided into two groups.Group A was treated with therapeutic soft contact lenses for 3 days after PRK and group B only for PRK.Corneal epithelial healing,haze and interrogate pain were graded and the follow up period was 6 months. Results Corneal epithelium was completely cured in 68% of cases on the 2nd day in group A after PRK and in 24% of patients in group B( P <0 05).Incidence rate of pain of 0 5 grade,1 grade and 2 grade was 58%,20% and 22% respectively in group A and 0,54% and 45% in group B( P <0 05).Incidence rate of haze in the 1st month,3rd month and 6th month was 50%,32% and 14% respectively in group A and 83%,70% and 35% in group B( P <0 05). Conclusion Therapeutic soft contact lenses can promote corneal epithelial healing and decrease occurrence of haze.Covering of corneal wound with therapeutic soft contact lenses after PRK plays a key role in decreasing haze.