高透氧性硬性角膜接触镜并发症的处理及预防

Preventions and treatment of the complications induced by the rigid gas permeable contact lens

目的:通过观察配戴高透氧性硬性角膜接触镜(rigid gas permeable contact lens,RGP)的并发症,探讨RGP并发症的处理及预防。方法:配戴RGP患者54例101眼,分别记录配戴前后视力、屈光度、裂隙灯及角膜地形图结果,随访观察12mo,研究分析并发症发生情况及相应处理的有效性。结果:本组患者在配戴过程中发生的并发症主要有干涩不适16眼(15.8%);异物感8眼(7.9%);角膜上皮点状脱落7眼(6.9%);结膜过敏性炎症3眼(3.0%);角膜外伤1眼(1.0%);眼镜护理不当15眼(14.9%),包括镜片污浊划痕10眼,镜片丢失3眼,镜片碎裂2眼。除有2例因眼部不适停戴外其他患者经对症处理均能满意接受配戴。结论:详细的试戴前检查、正规验配过程及严格随诊可以有效预防并减少RGP并发症的发生。

AIM： To assess the complications induced by wearing rigid gas permeable contact lens（RGP）, and to discuss the preventions and treatments of theses complications. METHODS. Totally 54 patients 101 eyes who underwent RGP therapy were observed alone for 1 year. The patients complains were recorded, routine eye examinations were conducted（including vision, refraction, ocular pressure, slit - lamp findings and corneal topography ）, the abnormal findings and the treatments were analyzed. RESULTS= The abnormal findings included dryness in 16 eyes（15.8% ）, foreign body sensation 8 eyes （7.9%）, spotty staining 7 eyes （ 6. 9%）, allergic inflammation of conjunctiva 3 eyes （3. 0%）; corneal trauma 1 eye （1.0%）; improper glasses care 15 eyes （14. 9%）, including the scratched lens 10 eyes, lens lost 3 eyes, fragmentation 2 eyes. Patients all got satisfied outcome with symptomatic treatment except 2 cases not wearing glasses due to eye discomfort. Appropriated treatments were performed. CONCLUSION= The detail examination, the operation and strict following up are effective methods to preserve the complications according to the RGP.