应用高透氧性角膜接触镜在准分子激光角膜切削术后的病原学分析

Study of bacterial contamination associated with bandage contact lenses after photorefractive keratectomy

目的针对准分子激光屈光性角膜切削术（PRK）后所使用的绷带式高透氧性角膜接触镜的病原学进行分析。方法对接受PRK手术的50例（100只眼）患者,手术前取结膜囊分泌物进行细菌学培养。术后给予术眼配戴高透氧性绷带式角膜接触镜,术后第6-8天摘除角膜接触镜,将角膜接触镜进行细菌学检测,并同时再次取结膜囊分泌物进行细菌学培养。并将接触镜培养阳性的患者与培养阴性的患者分组对比,分析两组间矫正视力、眼压、角膜厚度等相关影响因素的差异性。结果 100片角膜接触镜中,3片（3%）细菌学检测结果呈阳性,均为表皮葡萄球菌。所有患者术前、术后结膜囊均未监测到细菌,术后均未见眼部感染表现。阳性组和阴性组间,泪液分泌量存在差异,可能与培养阳性有相关。结论 PRK术后使用的高透氧性绷带式角膜接触镜具有发生细菌污染的可能,尤其对于泪液分泌量较少的患者,其角膜接触镜发生感染机率较高。手术前后合理用药可有效控制接触镜中细菌的繁殖。

Objective To evaluate the occurrence rate and agents of the bacterial contamination of bandage contact lenses after photorefractive keratectomy（PRK）.Methods In a prospective study,50patients（100eyes）underwent PRK.Conjunctival sac secreta were placed onto chocolate agar before PRK.All patients accepted bandage contact lenses and anti-inflammatory drug therapy.Contact lenses and conjunctival sac secreta were placed onto chocolate agar after PRK.Corrected visual acuity,intraocular pressure and corneal thickness were compared in the 2groups.Results Among 100 pieces of cornea contact lens,3pieces（3%）were tested positive for bacteria detection and bacteria were staphylococcus epidermis.All conjunctival sac secreta of preoperative and postoperative were not detected bacteria,postoperative eye infection was not found.Between the positive and negative groups,tear secretion,may be related to cultivate positive correlation.Conclusion Bacterial contamination is possible when using bandage contact lenses after PRK,specially for patients with less tear secretion.