准分子激光屈光性角膜切削术后高透氧性角膜接触镜的应用

Clinical research on high oxygen permeable contact lens used after photorefractive keratectomy surgery

目的:探讨高透氧性角膜接触镜对准分子激光屈光性角膜切削术(photorefractive keratectomy,PRK)后眼刺激症状及角膜上皮愈合的影响。方法:共95例190眼PRK病例,术后随机选择一只眼戴软性亲水性高透氧的角膜接触镜,另一只眼配戴普通月抛型角膜接触镜。术后记录术眼自觉症状,观察角膜上皮愈合情况,检查术后6mo裸眼视力,同时进行haze评分。结果:高透氧角膜接触镜组术眼视物模糊、眼痛、畏光均轻于普通月抛型角膜接触镜组,两组比较差异有统计学意义(P<0.05)。高透氧角膜接触镜组平均角膜上皮愈合时间分别为3.11±2.12d,普通月抛型角膜接触镜组为4.02±2.21d,两组比较差异有统计学意义(P<0.05)。角膜上皮72h内愈合者高透氧角膜接触镜组占46%,普通月抛型角膜接触镜组占36%。术后第7d裸眼视力高于1.0者高透氧角膜接触镜组为60眼(63%),普通月抛型角膜接触镜组为48眼(51%)。术后6mo两组术后裸眼视力无显著性差异(P=0.35),两组haze发生率比较无显著性差异(P=0.55)。结论:PRK术后使用高透氧性角膜接触镜可以明显减轻术后患者的角膜刺激症状,减少患者的术后不适感,缩短角膜上皮的愈合时间。

AIM. To evaluate the outcome of high oxygen permeable contact lens used after photorefractive keratectomy （PRK） surgery. METHODS： Totally 95 patients （190 eyes） after PRK were included. Patients were randomly assigned to wear high oxygen permeable contact lens in one eye and normal lens in the fellow eye after surgery. The subjective symptoms and corneal epithelial status after PRK were evaluated. Uncorrected visual acuity （UCVA） and haze were assessed at 6 months after PRK. RESULTS： Complaints of blurred vision, pain and photophobia were statistically more among the normal lens group than high oxygen permeable contact lens group （P〈0.05）. The time of corneal epithelium recovery was 3.11 ±2.12 days in the high oxygen permeable contact lens group and 4.02±2.21 days in the normal lens group respectively. There was statistically significant difference between two groups （ P〈 0.05）. The wholly healing of corneal epithelium happened in 46% and 36% eyes at 72 hours after surgery respectively. Seven days after surgery, 60 eyes （63%） and 48 eyes （51%） achieved UCVA better than 1.0 respectively （ P= 0.35）. There was no difference in UCVA and haze 6 months after surgery（P= 0.55）. CONCLUSION ： High oxygen permeable contact lens can significantly produce less the corneal irritated symptoms, reduce the discomfort feeling and promote healing of corneal epithelium after PRK.