角膜绷带镜辅助翼状胬肉切除术后角膜上皮修复效果

The repair effect of corneal epithelium after pterygiumsurgery with bandage contact lenses

目的监测角膜绷带镜辅助翼状胬肉切除术后角膜上皮的修复情况。方法临床病例对照研究。对2014年1月至2015年6月于海南省眼科医院选取26例（52只眼）双眼翼状胬肉患者，双眼均行单纯翼状胬肉切除手术治疗，将52只眼随机分成两组：A组26只眼术后给予配戴角膜绷带镜，B组26只眼（同一患者的另一眼）为对照组。分别于术后第1、3、5 d检测角膜情况，直至角膜上皮修复。用角膜荧光染色检测上皮是否完全修复。术后疼痛通过视觉模拟评分法评价。结果通过角膜荧光染色评估，角膜绷带镜组患者角膜上皮完全修复的平均时间为（4.4±1.3）d，对照组为（5.8±1.7）d，两组差异有统计学意义（t=12.33，P 〈0.01）。带角膜绷带镜患者角膜上皮均完全恢复且无出现感染等情况。视觉模拟评分法评价得分显示角膜绷带镜组患者在相同时间点其疼痛程度较对照组低，差异有统计学意义（t=-3.92、-3.18、-2.86、-2.26、-1.89、-1.63，P均〈0.05）。结论角膜绷带镜可有效地促进角膜上皮修复及改善术后的舒适度，是翼状胬肉切除术后较好的辅助治疗措施。

Objective To monitor the repair effect of corneal epithelium after pterygium surgery assisted by bandage corneal contact lenses. Methods Twenty-six patients （52 eyes） with pterygium undergoing pterygium excision were randomly allocated into 2 groups： 26 eyes were covered with bandage corneal contact lenses at the end of surgery and 26 eyes （the other eye of the same pa- tient） served as a control. Fluorescein staining of the cornea were performed sequentially on day 1, day 3, day 5, and then every other day until the end of re-epithelialization after surgery. Complete corneal epithelial healing was verified with fluorescein staining after removal of the bandage corneal contact lenses. Postsurgical pain was evaluated using the visual analogue scale （VAS）. Results Based on the assessment by fluorescein staining, the average time line for re-epithelialization in the ban- dage corneal contact lenses group was 4.4±1.3 days while in the control group it was 5.8±1.7 days （t =12.33, P 〈0.01）. All patients of bandage corneal contact lenses group were completely re-epitheliali- zation without any infection. VAS scores reported lower pain levels in the bandage corneal contact lenses group compared to the control group at each time point （t =-3.92, -3.18, -2.86, -2.26, -1.89, -1.63, both P 〈0.05）. Conclusions Bandage corneal contact lens is recommended as an adjuvant therapy after pterygium surgery for its efficacy in improving re-epithelialization and postoperative comfort.