亲水性软性角膜接触镜在眼外伤治疗中的应用

Application of therapeutic soft contact lenses in ocular trauma

目的 :探讨治疗性亲水性软性角膜接触镜的适应证与效果。方法 :对眼部化学烧伤与热烧伤所致的上皮缺损 33例 34眼、手术创伤等原因导致的大泡性角膜病变 30例以及角膜上皮剥脱 6例 7眼 ,角膜创口缝线刺激者 15例 15眼 ,及角膜小裂孔伤 2例 2眼等患者 ,用连续配戴治疗性亲水性软性角膜接触镜治疗 ,联用抗生素眼药水、人工泪液和爱丽眼药水治疗。结果 :化学与热烧伤后上皮缺损戴镜后治愈率为 82 .4% ;白内障手术创伤等因素影响 ,导致内皮失代偿引起大泡性角膜病变 ,症状缓解率达 10 0 % ;7例机械性外伤所致角膜上皮擦伤和反复性角膜上皮剥脱治愈率 10 0 % ;用于缓解创口缝线的刺激和促进角膜小穿孔等处理也有明显效果。结论 :连续戴用亲水性软性角膜接触镜对大泡性角膜病变引起的疼痛及缝线刺激可消除或缓解 ,对化学烧伤、壬烧伤及机械性外伤角膜上皮缺损及角膜小穿孔也具有促进愈合的效果。

Objective:To evaluate the indications and effects of therapeutic soft contact lenses in the treatment of ocular trauma.Methods:All patients were treated with extended wear soft contact lenses and topical antibiotic eyedrops, including 33 cases (34 eyes) with ocular chemical or thermal burns and epithelial defects, 30 cases with bullous keratopathy after cataract extraction and I0L implantation or antiglaucoma surgery, 7 cases with corneal abrasions secondary to trauma, 15 cases with suture irritation and 2 cases with a small penetrating injury to the cornea.Results:82.4% of the cases with corneal epithelial defects from ocular chemical or thermal burns were cured. In the 30 cases of bullous keratopathy, the remission rate was 100% from symptoms of irritation. The cure rate was 100% in 7 cases of corneal epithelial abrasions. All patients also recovered from corneal suture irritability.Conclusion:Extended wear soft contact lenses have good curative effects in the remission of painful, irritating symptoms from bullous keratopathy and corneal sutures, post-traumatic corneal epithelial defects and small penetrating injuries.