两种角膜接触镜在LASEK术后应用的比较

Comparison between two kinds of contact lenses after LASEK

【摘要】目的探讨两种持续佩戴型软性治疗性角膜接触镜在准分子激光上皮下角膜磨镶术（LASEK）后应用的临床安全性和有效性。方法LASEK受术者35例（70眼），均为双眼手术，术后右眼戴博士伦纯视接触镜，左眼戴视康日夜型接触镜，均连续佩戴7d。术后3d及7d观察镜片的沉淀物及角膜上皮水肿情况，并由其本人对两眼主觉症状（眼痛，异物感）进行评分。结果纯视镜沉淀物较视康镜多：术后3d，Z=-2．451，P=0．014；术后7d，Z=-3．027，P=0．002。角膜上皮水肿情况两种镜片间差异无统计学意义：术后3d，Z=-0．386，P=0．700，术后7d，Z=-0．447，P=0．655。两眼的自觉症状在术后3d和7d差异均无统计学意义：眼痛感术后3d，Z=-0．471，P=0．638；术后7d，Z=-0．333，P=0．739；异物感术后3d，Z=-1．330，P=0．183，术后7d，Z=-0．277，P：0．782。结论两种连续佩戴型软性角膜接触镜对LASEK术后上皮瓣的恢复是安全有效的，与博士伦纯视镜相比，视康日夜型镜片后沉淀物更少些。

Objective To investigate the safety and effectiveness between two kinds of therapeutic soft corneal contact lenses after LASEK. Methods Seventy eyes of 35 cases were treated with LASEK. Their right eyes worn Bausch ＆ Lomb purevision lenses, and the left eyes worn CIBA Vision day and night lenses after surgery. The lenses were worn continuously for 7 days. The deposits on the lenses and corneal epithelial edema were recorded 3 and 7 days after the surgery. The subjective symptom was graded by the patients. Results The purevision lenses had more deposits than CIBA at the 3 and 7 days after the operation （Z = -2. 451, P =0. 014; Z = -3. 027, P =0. 002）. The difference in corneal epithelial edema was not statistically significant between the two sorts of lenses （ 3 days after the surgery, Z = - 0. 386, P = 0. 700 ; 7 days after the surgery, Z = - 0. 447, P -- 0.655 ）. The difference in symptoms of pain was not statistically significant between the right and the left eyes at the 3 and 7 days after the operation （Z = -O. 471, P = O. 638 ; Z = - 0. 333, P = 0.739）. Foreign body sensation （FBS） between two kinds of lenses was similar （Z = - 1. 330, P =0. 183 ; Z = -0. 277, P =0. 782）. Conclusion Two kinds of therapeutic soft corneal contact lenses are safe and effective for the recovery of epithelial flap after LASEK. The CIBA Vision day and night lenses has less deposits than the Bausch ＆ Lomb purevision lenses.