角膜绷带镜对复发性翼状胬肉术后角膜上皮愈合和疼痛评分及角膜规则度的影响

Effect of bandage contact lens on the corneal epithelium healing, degree of pain and corneal surface after recurrent pterygium excision

目的:研究角膜绷带镜对复发性翼状胬肉患者术后角膜上皮愈合、疼痛程度评分和角膜表面规则度的影响。方法:回顾性病例研究。将2015-09/2017-09就诊于湖州师范学院附属第一医院并行手术治疗的64例64眼复发性翼状胬肉患者,根据术后是否使用角膜绷带镜分组,A组34眼术后配戴1wk角膜绷带镜,B组30眼术后不使用角膜绷带镜。采用荧光素钠角膜染色法评价翼状胬肉患者术后1d和1wk时角膜上皮愈合程度;通过视觉模拟评分法评估患者术后2h,1d,1wk时疼痛程度;采用角膜地形图系统分析术前及术后1mo时角膜表面规则指数、角膜表面不对称指数和角膜散光情况。结果:A组患者术后1d,1wk时角膜上皮愈合评分与B组相比,差异均有统计学意义(P<0.01)。A组患者术后各时间点的疼痛程度评分均明显低于B组,差异均有统计学意义(P<0.01)。A组患者术前角膜表面规则指数、角膜表面不对称指数及角膜散光与B组相比,差异无统计学意义(P>0.05),而术后1mo时角膜表面规则指数、角膜表面不对称指数及角膜散光与B组相比,差异均有统计学意义(P<0.01)。结论:复发性翼状胬肉患者术后配戴角膜绷带镜,有助于角膜上皮愈合,减轻术后刺激症状,改善角膜表面规则度,降低术后角膜散光。

AIM:To assess the effect of bandage contact lens on the corneal epithelium healing condition,degree of pain and corneal surface after recurrent pterygium excision.METHODS:Retrospective case-series study.A total of 64 patients(64 eyes)with recurrent pterygium who received treatment in the First Affiliated Hospital of Huzhou University from September 2015 to September 2017 were divided into Group A(34 cases with bandage contact lens group)and Group B(30 cases without bandage contact lens group).The healing status of corneal epithelium was evaluated by fluorescent staining between the two groups at 1d and 1wk after surgery.The degree of pain was assessed between the two groups at 2h,1d and 1wk after recurrent pterygium excision by visual analogue score.Computerized corneal topography was performed on all cases with recurrent pterygium before and 1mo after successful excision surgery.Statistical analysis of surface regularity index(SRI),surface asymmetry index(SAI)and corneal astigmatism(CA),was done before and 1mo after surgery.RESULTS:Average scores of corneal epithelium healing condition at 1d and 1wk were better in Group A than that in Group B(P<0.01).The mean scores of pain values at 2h,1d and 1wk after surgery in Group A were significantly lower than that in Group B respectively(P<0.01).The indicators reflecting corneal surface at 1mo after surgery,including SRI,SAI,CA,were significantly lower in Group A than that in Group B(P<0.01),while they were not significantly different before surgery between the two groups(P>0.05).CONCLUSION:Bandage contact lenses could significantly promote the healing status of corneal epithelium,release pain response and improve corneal refractive status after recurrent pterygium excision.