表浅真菌性角膜溃疡术后应用治疗性接触镜临床疗效观察

Clinical effect of contact lens treated superficial fungal corneal ulcer after operation

目的 观察表浅真菌性角膜溃疡行病灶切除联合冷凝及羊膜覆盖手术,术后辅助应用治疗性角膜接触镜的临床效果.方法 临床病例对照研究.对2012年5月至2014年1月在沈阳军区总医院眼科确诊的表浅真菌性角膜溃疡患者93例（93只眼）,均采用角膜病灶切除联合冷凝及羊膜覆盖术,术后按数字单偶法随机分为戴镜组（48只眼）,给予配戴角膜接触镜;对照组（45只眼）为不配戴角膜接触镜.戴镜时间1～3个月,角膜接触镜每21天更换一次.术后随访时间2～6个月.结果 戴镜组临床总有效率87.50％ （42/48）,显著高于对照组66.67％ （30/45）,差异有统计学意义（x2=5.77,P ＜0.05）.戴镜组角膜溃疡治愈时间为（16±2）d,显著少于对照组（24±3）d,差异有统计学意义（t =15.03,P＜0.05）.结论 表浅真菌性角膜溃疡患者术后连续配戴软性角膜接触镜可以改善临床症状,促进角膜溃疡愈合,提高临床疗效.

Objective To observe the clinical effect of auxiliary application of contact lens in superficial fungal corneal ulcer treated with lesion keratectomy combined with cryotherapy and biological amnion covering.Methods The 93 patients（93 eyes）that had been diagnosed with fungal comeal ulcer were treated with lesion keratectomy combined with cryotherapy and biological amnion covering in our hospital from May 2012 to January 2013.Those were divided into contact lens group （48 eyes）and control group（without contact lens group）（45 eyes）at random.The contact lens group was treated with wearing contact lens for 1 month to 3 months and changing them every 21 days.All the cases were followed up for 2 to 6 months.Results The effective rate in the contact lens group（87.50%）was significantly higher than those in the control group （66.67%） （P 〈0.05）.The cure time of corneal ulcer in the contact lens（16±2 days）,was significantly shorter than control group（24± 3 days）（P 〈0.05）.Conclusions Wearing soft contact lens continuously in superficial fungal corneal ulcer can improve clinical symptoms,promote ulcer healing and improve curative effect.