翼状胬肉切除联合自体游离球结膜瓣移植术后戴角膜绷带镜的临床治疗效果

Clinical effect of wearing corneal bandage mirror after pterygium excision combined with conjunctival autograft

目的探讨采取翼状胬肉切除与自体游离球结膜瓣移植术联合方案治疗后戴角膜绷带镜对康复的促进作用。方法前瞻性病例对照研究。采取翼状胬肉切除与自体游离球结膜瓣移植术联合方案治疗的患者80例(80只眼),均为我院眼科2018年1月至2020年9月收治,医院伦理委员会通过,随机分组,就术后常规康复(对照组,n=40)与戴角膜绷带镜康复(观察组,n=40)角膜上皮恢复总有效率及术前以及术后不同时点泪膜破裂时间(BUT)评分、干眼症状(OSDI)评分、角膜荧光素染色(CFS)评分,术后24 h舒适度展开对比。结果观察组术后角膜上皮恢复总有效率高于对照组(P<0.05)。两组在术前BUT经评测无差异(P>0.05),术后2周和1个月,评测值均有下降,但观察组下降程度小于对照组(P<0.05),术后3个月略高于对照组,但无统计学差异(P>0.05)。两组在术前OSDI经评测无差异(P>0.05),术后2周、术后1个月评测值均有升高,但观察组升高程度小于对照组(P<0.05);术后3个月均恢复至术前水平,差异无统计学意义(P>0.05)。两组在术前CFS经评测无差异(P>0.05),术后2周、1个月均有升高,但观察组升高程度小于对照组,两组术后3个月评测值无统计学差异(P>0.05)。观察组术后24h舒适度各维度评分经评测均低于对照组(P<0.05)。结论应用翼状胬肉切除与自体游离球结膜瓣移植术联合方案治疗的患者,术后采用戴角膜绷带镜方案辅助康复,可提高角膜上皮恢复效果,增强泪膜稳定性,减轻干眼等症状,加快眼表环境恢复进程,降低异常感、眼睁困难等不适症状程度。

Objective To explore the effect of wearing corneal bandage mirror after pterygium excision and conjunctival autograft.Methods 80 cases of pterygium excision and conjunctival autograft were randomly divided into two groups.Approved by the Hospital Ethics Committee,The total effective rate of corneal epithelial recovery and tear film rupture before and after operation were compared between routine rehabilitation(control group,nn=40)and wearing corneal bandage mirror rehabilitation(observation group,n=40)The results showed that there were no significant differences between the two groups in the scores of but,osdi and CFS.Results the total effective rate of corneal epithelial recovery in the observation group was higher than that in the control group(P<0.05).There was no difference between the two groups(P>0.05)in the evaluation of the preoperative but 2 weeks and 1 month after the operation,the evaluation value decreased,but the decrease degree of the observation group was less than that of the control group(P<0.05),and 3 months after the operation was slightly higher than that of the control group,but there was no statistical difference(P>0.05).There was no difference in osdi between the two groups(P>0.05).The value of osdi in the observation group was lower than that in the control group(P<0.05)at 2 weeks and 1 month after operation,but the difference was not statistically significant(P>0.05).There was no difference between the two groups in preoperative CFS evaluation(P>0.05).The level of CFS in the observation group was lower than that in the control group at 2 weeks and 1 month after operation,but there was no significant difference between the two groups at 3 months after operation(P>0.05).After 24 hours,the comfort scores of each dimension in the observation group were lower than those in the control group(P<0.05).Conclusions In the treatment of pterygium excision combined with conjunctival flap transplantation,wearing corneal bandage mirror can improve the recovery of corneal epithelium,enhance the stability of tear film,alleviate dry eye and other symptoms,accelerate the recovery of ocular surface environment,and reduce the degree of discomfort such as abnormal feeling and difficulty in opening eyes.