绷带型角膜接触镜在翼状胬肉术后的应用与评价

Evaluation the effects of bandage contact lenses application after pteygium excision surgeries

目的观察绷带型角膜接触镜对翼状胬肉术后患者的角膜刺激症状、角膜创面的影响情况。方法将原发性单侧翼状胬肉患者60例(60只眼)随机平均分成戴镜组和对照组各30例(30只眼),两组均实施单纯翼状胬肉切除联合自体角膜缘干细胞移植术,戴镜组在手术结束时角结膜表面配戴绷带型角膜接触镜,术后7 d取下角膜接触镜,对照组不做任何处理。观察术后6 h、1 d、2 d、3 d、7 d两组患者眼部刺激症状的差异及两组患者术后3 d、7 d角膜上皮愈合情况。结果术后6 h、1 d、2 d、3 d、7 d两组患者疼痛程度评分:戴镜组分别为1.40±0.62、0.93±0.45、0.47±0.51、0.27±0.45、0.14±0.35分,对照组分别为2.87±0.90、1.60±0.72、1.47±0.73、0.73±0.58、0.30±0.47分;其中术后6 h、1 d、2 d、3 d绷带型角膜接触镜组患者疼痛程度评分均较对照组显著降低P<0.05)。术后3 d、7 d角膜上皮愈合情况比较,戴镜组为0.80±0.93、0.20±0.55分,对照组为1.40±0.81、0.47±0.82分,其中术后3 d绷带型角膜接触镜组患者角膜上皮愈合评分均较对照组显著降低(P<0.05)。结论治疗性绷带型角膜接触镜能加速翼状胬肉术后角膜创面的修复,有效缓解患者的眼部刺激症状,并能提高临床工作者的工作效率,值得推广应用。

Objective To investigate the effects of bandage contact lenses on corneal irritation and wound healing after pterygium excision surgeries. Methods Sixty patients（ 60 eyes） with primary unilateral pterygium randomly were divided into two groups（ n = 30 for each）. Both groups received pterygium excision combined with limbal stem cell transplantation. Patients of group 1 wore bandage contact lenses for 7 days after the surgery,while patients of group 2 did not receive any further treatment after the surgery. The differences in eye irritation（ at 6h,1d,2d,3d and 7d） and corneal epithelial healing（ at 3d and 7d） between the two groups were observed. Results Mean pain scores were significantly lower in group 1（ wore bandage contact lenses） than in group 2（ did not wear bandage contact lenses） at 6h,1d,2d and 3d after the surgery（ P〈0. 05）. Mean scores of corneal epithelial healing at 3d were significantly better in group 1 than in group2（ P〈0. 05）,but not significantly different at 7d after the surgery. Conclusion Therapeutic soft contact lens will accelerate the recovery of corneal wounds,effectively alleviate eye irritation,and improve the healthcare efficiency. Therefore it is worthy to be promoted in the clinic.