翼状胬肉切除联合自体角膜缘结膜移植术后绷带镜的应用

Evaluation of therapeutic contact lenses used in pterygium surgery combined with limbal conjunctival autograft transplantation

目的:探讨翼状胬肉切除联合自体角膜缘结膜移植术后应用角膜绷带镜的临床效果。方法:随机对照临床试验。选取2017-11/2018-10在我院眼科接受手术治疗的原发性翼状胬肉患者92例92眼,按随机数字表法分为角膜绷带镜组和弹性绷带组,每组各46眼。两组患者均接受翼状胬肉切除联合自体角膜缘结膜移植术,术毕角膜绷带镜组患者配戴角膜接触镜,弹性绷带组患者在术毕结膜囊内涂红霉素眼膏,弹性绷带包眼。裂隙灯显微镜观察术后第1、4、7d角膜上皮创面,对角膜上皮愈合情况进行评分;运用评价视觉模拟评分法评价术后7d疼痛情况;运用问卷评分法评价术后7d舒适情况(包括异物感、流泪)。结果:术后第1d和第7d两组患者角膜上皮愈合情况无明显差异,而术后第4d角膜绷带镜组患者角膜上皮愈合优于弹性绷带组(P<0.05)。此外,角膜绷带镜组患者术后7d疼痛感评分低于弹性绷带组,眼部舒适度评分高于弹性绷带组(P<0.05)。结论:角膜绷带镜不仅可以有效促进角膜上皮愈合,还可以有效减轻疼痛,提高眼部舒适感。

AIM:To evaluate the function of therapeutic contact lenses used in pterygium surgery combined with limbal conjunctival autograft transplantation (LCAT). METHODS: Prospective randomized controlled study. Ninety-two patients (ninety-two eyes) with primary pterygium who underwent pterygium surgery combined with LCAT in Ophthalmology of the First Affiliated Hospital of Xi'an Jiaotong University from November 2017 to October 2018. The patients were randomly divided into a therapeutic contact lenses group and a tight bandage group. The corneal epithelial wounds were observed on the 1 st , 4 th , and 7 th day after operation by slit lamp microscope. Then, the postoperative pain was evaluated by the visual analog scale. Last, the questionnaire was used to evaluate the eye comfort level. RESULTS:There was no significant difference in corneal epithelial healing between the two groups on the first and seventh day after surgery. On the fourth day after surgery, the corneal epithelial healing was better in the therapeutic contact lenses group than in the tight bandage group ( P <0.05). In addition, the postoperative pain score in the therapeutic contact lenses group was lower than that in the tight bandage group ( P <0.05), and the eye comfort level was also higher than that in the tight bandage group ( P <0.05). CONCLUSION: The therapeutic contact lenses can not only effectively promote corneal epithelial healing, but also effectively reduce pain, improve eye comfort level and improve postoperative quality of life.