治疗性接触镜在表浅真菌性角膜溃疡术后的应用观察

Application of therapeutic contact lens to postoperative superficial fungal corneal ulcer

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 2012年5月—2013年1月在我院确诊的表浅真菌性角膜溃疡患者93例（93眼）,均采用角膜病灶切除联合冷凝及羊膜覆盖术,术后将其按随机数字表法分为（1）戴镜组（48眼）,给予配戴角膜接触镜;（2）对照组（45眼）,不配戴角膜接触镜。戴镜时间1-3个月。角膜接触镜每21 d更换1次。术后随访时间2-6个月。结果戴镜组临床总有效率为87.50%显著高于对照组的66.67%（P〈0.05）。戴镜组角膜溃疡治愈时间为（16±2）d,显著低于对照组的（24±3）d（P〈0.01）。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 lenses to superficial fungal corneal ulcer which has been treated with lesion keratectomy combined with cryotherapy and biological amnion covering. Methods Ninety-three patients（ 93 eyes） with fungal corneal ulcer,who had been treated with lesion keratectomy combined with cryotherapy and biological amnion covering in our hospital from May 2012 to January 2013,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 to 3months and changing them every 21 days. All the cases were followed up for 2 to 6 months. Results The effective rate（ 87. 50%）in the contact lens group was significantly higher than that（ 66. 67%） in the control group（ P〈0. 05）. The cure time（ 16 ± 2） d of corneal ulcer in the contact lens group was significantly shorter than that（ 24 ± 3） d in the control group（ P〈0. 05）. Conclusion Wearing soft contact lens continuously in those with postoperative superficial fungal corneal ulcer can alleviate clinical symptoms,promote ulcer healing and therefore improve curative effect.