绷带型角膜接触镜在治疗丝状角膜炎应用的临床分析

Clinical analysis of bandage contact lens applied in treatment of filamentary keratitis

目的探讨绷带型角膜接触镜应用治疗丝状角膜炎的有效性及安全性。方法采用前瞻性对照病例研究,观察该院2014年1—9月收治的丝状角膜炎患者80例（80眼）,随机分为2组：观察组和对照组,每组40例（40眼）。观察组采用刮除丝状物后配戴绷带型角膜接触镜联合贝复舒眼液治疗,对照组则采用单纯刮除丝状物后贝复舒眼液治疗。比较刮除丝状物后2 h、1 d、2 d、3周时2组患者的疼痛程度,并且对比3周后2组患者角膜上皮荧光素染色的评分差异。结果选取的2组患者在年龄、性别比例及丝状角膜炎病因等方面均差异无统计学意义（P〉0.05）。刮除丝状物后2 h、1 d、2 d、3周时2组患者疼痛程度评分：观察组分别为（1.22±0.43）分、（0.87±0.34）分、（0.56±0.28）分、（0.32±0.31）分,对照组分别为（2.81±0.71）分、（1.61±0.33）分、（0.93±0.35）分、（0.50±0.29）分。比较2组疼痛程度评分结果 ,观察组患者较对照组在2 h、1 d和2d时明显降低（P〈0.05）,其中2 h时P〈0.01,在3周时2组之间差异无统计学意义（P〉0.05）,刮除丝状物后3周角膜上皮荧光素染色评分观察组为（0.81±0.72）分,对照组为（1.14±0.68）分,2组间差异无统计学意义（P〉0.05）。观察组治愈率82.5%,有效率100%;对照组治愈率67.5%,有效率85%;随诊2-3周未见感染、复发等并发症发生。结论应用绷带型角膜接触镜治疗丝状角膜炎可以明显缩短恢复时间,提高治愈率和有效率,安全无复发,具有临床应用价值。

Objective To explore the efficacy and safety of bandage contact lens applied in treatment of filamentary keratitis. Methods A total of treated filamentary keratitis cases （80 eyes） from January 2014 to September 2014 were collected by prospec-tive controlled case study, and were randomly divided into treatment group and control group with 40 cases （40 eyes） consisted in each group. The treatment group wore bandage contact lens and dripped bFGF eye drops after scraping filaments. Control group were only removed filaments and dripped bFGF eye drops. The degree of pain after surgery were evaluated at 2 h, 1 d, 2 d, 3 w, and the scores of healing of corneal epithelial were assessed by fluorescein staining at 3 week. Results There are no significant differences between the ages, gender proportion and pathogenesis of filamentary keratitis in the two groups （P〉0.05）. The pain in-dex scores of two groups at 2 h, 1 d, 2 d, 3 w after surgery are as following： treatment group were （0.12 ± 0.43 ）score, （0.87 ± 0.34） score, （0.56 ± 0.28） score, （0.32 ± 0.31） score; Control group was （2.81 ± 0.71） score, （1.61 ± 0.33） score, （0.93 ± 0.35） score, （0.50 ± 0.29） score, separately. The scores of treatment group are significantly less than those of control group at the first three time points （all P〈0.05, and P〈0.01 at 2 h）, and no differences at 3 w between two groups （P〉0.05）. At the 3w after surgery, there is no significant difference in corneal epithelial fluorescein staining scores between the treatment group （0.81 ± 0.72） and control group （1.14 ± 0.68）（P〉0.05）. The curative rate of treatment group and control group was 82.5%and 67.5%, separately;the effective rate was 100% and 85%, separately. Follow-up was from 2 to 6 months, they were no infection, relapse and complica-tions. Conclusion Bandage contact lens applied in treatment of filamentary keratitis which could significantly shorten the time of recovery, improve the curative and effective rate, safety and relapse has the value of clinical application.