绷带型角膜接触镜在翼状胬肉术的应用

Clinical observation of bandage type corneal contact lens applied in pterygium excision

目的评价角膜接触镜在翼状胬肉切除术的临床疗效。方法采用前瞻性对照病例研究。观察2014年1月至2015年1月在云南省第一人民医院眼科接受翼状胬肉切除联合丝裂霉素C应用患者50例50只眼，按住院号末位数字奇偶数随机分为观察组和对照组，每组25例（25只眼）。观察组在手术结束时配戴绷带型角膜接触镜，术后5 d取出，对照组不做任何处理。比较两组患者术后2 h及1、2、3、5 d疼痛度、术后1、3、5 d角膜上皮荧光素染色评分及角膜上皮缺损面积的差异，并观察并发症的发生情况。结果两组患者年龄、性别及翼状胬肉大小差异均无统计学意义（P〉 0.05）。两组患者术后2 h及1、2、3、5 d疼痛程度评分：观察组患者疼痛程度评分均较对照组显著降低（P〈0.01）；术后1 d，3 d角膜上皮荧光素染色评分观察组较对照组低，两组间差异有统计学意义（P〈0.05）。两组术后复发率差异无统计学意义（P〉0.05）。结论绷带型角膜接触镜可明显减轻翼状胬肉切除术后疼痛反应，促进角膜上皮愈合。

Objective To explore the effect and security of bandage type corneal contact lens applied in pterygium excision combining with Mitomycin C. Methods A total of 50 cases （50 eyes） treated with pterygium excision combining with Mitomycin C from January 2014 to January 2015 were collected by prospective controlled case study, and were randomly and evenly divided into two groups： observation group and control group, 25 cases in each group （25 eyes）. Observation group were wore the bandage type corneal contact lens after surgery and took it down at day 5. The control group did not. The degree of pain after surgery were evaluated at 2 h, 1, 2, 3 and 5 days after surgery, meanwhile, the healing of corneal epithelial were assessed by fluorescein staining and differences of the corneal epithelial defect areas were observed at 1, 3, and 5 days after surgery. Re- suits There were no significant differences between the observation and control group in the percentage of age and gender and size of the pterygium （P 〉0.05）. After surgery, the degree of pain of treatment group was significantly decreased compared to control group, the difference was statistical- ly significant （P 〈0.01）. The score of corneal epithelium stained with fluorescein between of observa- tion group and control group postoperatively, the difference was statistically significant （P 〈0.05） in day 1 and 3. Conclusions Bandage contact lenses could significantly release pain response after pterygium excision and promote the healing of the corneal epithelium which is beneficial to improve the postoperative quality of life.