Effectiveness of toric soft contact lenses for vision correction in patients with different degrees of astigmatism: a real-world study

AIM:To assess the visual correction of patients with different degrees of astigmatism with toric soft contact lenses(TSC).METHODS:It was a real-world study with prospective and single-arm design.A total of 384 patients with astigmatism who came for TSC fitting and alignment from November 2022 to January 2023 were included.According to the difference in astigmatism,patients were divided into groups A(cylinder degree:-0.75 to-0.50 D),B(cylinder degree:-1.75 to-1.00 D)and C(cylinder degree≤-2.00 D),and followed up on the day of wear,1wk,1 and 3mo,mainly to observe visual acuity,refraction,lens fit,visual quality and comfort at 1wk after wear.The visual acuity success rate and the overall success rate of the fitting were evaluation indicators(taking into account the four dimensions of visual acuity,fitting,quality of vision and comfort).The visual acuity success rate was calculated by taking“corrected visual acuity with contact lenses is no less than 1 line or better than best spectacle-corrected visual acuity”(i.e.corrected visual acuity with contact lenses is 1 line below,equal to,one line above or more than best spectaclecorrected visual acuity)as the criterion for visual success,and the the overall success rate of the fitting was calculated by using the comprehensive indicators(visual acuity,fit,visual quality,comfort)to meet certain conditions as the judgment criteria for successful fitting.RESULTS:After 1wk of wearing TSC,the visual acuity success rates of patients were 100%(207/207),98.58%(139/141)and 97.22%(35/36)in the three groups,respectively,with residual cylinder closed to 0.The acceptability of the lens fitting was over 95%;the incidence of adverse visual symptoms was within 10%and the comfort acceptability was over 97%.The overall success rate of fitting for patients with high,medium and low astigmatism was 93.72%(194/207),90.78%(128/141)and 88.89%(32/36),respectively.CONCLUSION:TSC(model:G&G POP·CT)are effective in correcting astigmatism in patients with different degrees of astigmatism.

Oxygen permeability of soft contact lenses in different pH, osmolality and buffering solution

AIMTo determine the effect of pH, osmolality, and buffering system on the oxygen permeability (Dk) of soft contact lenses.METHODSTwo hydrogel lenses (nelfilcon A and etafilcon A) and 2 silicone hydrogel lenses (lotrafilcon A and balafilcon A) were used in the study. These lenses were incubated in phosphate-buffered saline (PBS) and borate-buffered saline (BBS) solutions adjusted by 0.8 pH increments to a pH in the range of 5.8-9.0 or in hypotonic (280 mOsmol/kg), isotonic (310 mOsmol/kg) and hypertonic (380 mOsmol/kg) PBS solutions. Polarographic method was used for measuring the Dk and lenses were stacked as 4 layers to correct the boundary effect.RESULTSDk values of all contact lenses measured in BBS solutions were more stable than those in PBS solutions. Especially the etafilcon A lens showed a relative big change compared with other types of contact lenses at the same conditions. When the osmolality of PBS solution increased from hypotonic to hypertonic, Dk of all contact lenses decreased. Variations in Dk existed depending on lens materials, etafilcon A lens was the most affected and nelfilcon A was the least affected by osmolality.CONCLUSIONFrom the result obtained, it is revealed that Dk of contact lenses is changed by the pH, osmolality, and buffering condition of tear. Thus, Dk of contact lens can be varied by the lens wearers' physiological and/or pathological conditions.

Corneal Wavefront Aberrations in Patients Wearing Multifocal Soft Contact Lenses for Myopia Control

Purpose: The purpose of this study was to evaluate the change in corneal wavefront aberrations in young adults who have been fit with multifocal soft contact lenses for myopia progression control. Findings have been analyzed for statistical significance and clinical relevance and compared to reportedly successful Orthokeratology outcomes. Methods: The dominant eye of 40 participants (27 women, 13 men;mean age 27.3 ± 3.2 years;range 23 to 39 years) was fit with Proclear Multifocal center distance lenses (Coopervision, Pleasanton, USA) having a variety of distance powers and reading additions. Refractive errors were limited to a range of –6.00 D up to +1.00 D of sphere, and no greater than –1.00 D of cylinder. Corneal wavefront measurements were performed over 6 mm diameters with a Zeiss Atlas 9000 corneal topographer (Zeiss Meditec, Dublin, USA) prior to, and following lens fitting. Data were converted into rectangular Fourier optics terms M, J0, J45 and RMS values for each reading addition were statistically analyzed. Following evaluation of statistical significance and clinical relevance, results were compared to published data from successful Orthokeratology treatments. Results: Statistically significant changes in higher order aberrations were detected for lenses of all reading additions. Lens groups with higher Add-powers demonstrated stronger changes with increased significance. Final RMS values relating to 2nd, 3rd and 4th Zernike Orders reached clinical significance with a wavefront error of 0.10 μm, the equivalent of 0.25D. Moreover, as Add-powers increased, 3rd and 4th order aberrations likewise showed an increase. Pre-fitting astigmatism values accounted for the highest recorded aberrations and remained predominantly unchanged. Conclusion: Proclear Multifocal center-distance contact lenses were found to increase higher order wavefront aberrations in a manner dependent on their Add-power. In comparison to successful Orthokeratology outcomes, the amounts of resulting aberrations are notably different.

Is the Use of Empirically Designed Custom Soft Contact Lenses a Good Option for Challenging Patients?

Purpose: Reasons for the lack of success for contact lens patients range from poor fit, to discomfort or to a less than optimum wearing schedule. This project was a preliminary investigation of customized soft toric contact lenses as an alternative for unsuccessful contact lens patients or potential drop-outs. Methods: Fifteen healthy non-compromised, previously unsuccessful contact lens wearing patients (13 women, 2 men) with ages from 21 to 33 years (25.1 ± 2.7 years) were the subjects for this study. They were empirically fitted with 15 astigmatic and 5 spherical customized SpecialEyes soft contact lenses. Visual acuities, comfort, lens movement, and rotation were evaluated. Results: Patients fitted with customized SpecialEyes soft contact lenses had statistically significant better visual acuities than with Phoropter Manifest Refraction. The lenses used in this study centered well and moved no more than 1 mm upon each blink. Lens rotation was less than 10 degrees for all toric lenses. Patients gave very positive vision and comfort ratings. Conclusion: This preliminary study supports the application of a software program to empirically design and manufacture Special Eyes custom soft lenses based upon corneal topographical parameters and subjective manifest refraction for those patients who either have challenging corneal parameters, high sphero-cylindrical prescriptions, or are currently dissatisfied with their contact lenses and are potential drop-outs.

Visual quality of juvenile myopes wearing multifocal soft contact lenses

Background:It is unclear whether multifocal soft contact lenses(MFSCLs)affect visual quality when they are used for myopia control in juvenile myopes.The aim of this study was,therefore,to investigate the effect of MFSCLs on visual quality among juvenile myopia subjects.Methods:In a prospective,intervention study,thirty-three juvenile myopes were enrolled.Visual perception was assessed by a quality of vision(QoV)questionnaire with spectacles at baseline and after 1 month of MFSCL wear.At the one-month visit,the high(96%)contrast distance visual acuity(distance HCVA)and low(10%)contrast distance visual acuity(distance LCVA)were measured with single vision spectacle lenses,single vision soft contact lenses(SVSCLs)and MFSCLs in a random order.Wavefront aberrations were measured with SVSCLs,with MFSCLs,and without any correction.Results:Neither distance HCVA(p>0.05)nor distance LCVA(p>0.05)revealed any significant difference between MFSCLs,SVSCLs and single vision spectacle lenses.The overall score(the sum of ten symptoms)of the QoV questionnaire did not show a statistically significant difference between spectacles at baseline and after 1 month of MFSCL wear(p=0.357).The results showed that the frequency(p<0.001),severity(p=0.001)and bothersome degree(p=0.016)of halos were significantly worse when wearing MFSCLs than when wearing single vision spectacle lenses.In contrast,the bothersome degree caused by focusing difficulty(p=0.046)and the frequency of difficulty in judging distance or depth perception(p=0.046)were better when wearing MFSCLs than when wearing single vision spectacle lenses.Compared with the naked eye,MFSCLs increased the total aberrations(p<0.001),higher-order aberrations(p<0.001),trefoil(p=0.023),coma aberrations(p<0.001)and spherical aberrations(SA)(p<0.001).Compared with the SVSCLs,MFSCLs increased the total aberrations(p<0.001),higher-order aberrations(p<0.001),coma aberrations(p<0.001)and SA(p<0.001).The direction of SA was more positive(p<0.001)with the MFSCLs and more negative(p=0.001)with the SVSCLs compared with the naked eye.Conclusions:Wearing MFSCLs can provide satisfactory corrected visual acuity(both distance HCVA and distance LCVA).Although the lenses increased the aberrations,such as total aberrations and higher-order aberrations,there were few adverse effects on the distance HCVA,distance LCVA and visual perception after 1 month of MFSCL use.

Visual quality of juvenile myopes wearing multifocal soft contact lenses

Background:It is unclear whether multifocal soft contact lenses(MFSCLs)affect visual quality when they are used for myopia control in juvenile myopes.The aim of this study was,therefore,to investigate the effect of MFSCLs on visual quality among juvenile myopia subjects.Methods:In a prospective,intervention study,33 juvenile myopes were enrolled.Visual perception was assessed by a quality of vision(QoV)questionnaire with spectacles at baseline and after one month of MFSCL wear.At the one month visit,the high(96%)contrast distance visual acuity(distance HCVA)and low(10%)contrast distance visual acuity(distance LCVA)were measured with single-vision spectacle lenses,single-vision soft contact lenses(SVSCLs)and MFSCLs in a random order.Wavefront aberrations Were measured with SVSCLs,MFSCLs and,without anycorrection.Results:Neither distance HCVA(P>0.05)nor distance LCVA(P>0.05)revealed any significant difference between MFSCLs,SVSCLs and single-vision spectacle lenses.The overall score(the sum of ten symptoms)of the QoV questionnaire did not show a statistically significant difference between spectacles at baseline and after one month of MFSCL wear(P=0.357).The results showed that the frequency(P<0.001),severity(P=0.001)and bothersome degree(P=0.016)of halos were significantly worse when wearing MFSCLs than when wearing single-vision spectacle lenses.In contrast,the bothersome degree caused by focusing difficulty(P=0.046)and the frequency of difficulty in judging distance or depth perception(P=0.046)were better when wearing MFSCLs than when wearing single-vision spectacle lenses.Compared with the naked eye,MFSCLs increased the total aberrations(P<0.001),higher-order aberrations(P<0.001),trefoil(P=0.023),coma aberrations(P<0.001)and spherical aberrations(SA)(P<0.001).Compared with the SVSCLs,MFSCLs increased the total aberrations(P<0.001),higher-order aberrations(P<0.001),coma aberrations(P<0.001)and SA(P<0.001).The direction of SA was more positive(P<0.001)with the MFSCLs and more negative(P=0.001)with the SVSCLs compared with the naked eye.Conclusions:Wearing MFSCLs can provide satisfactory corrected visual acuity(both distance HCVA and distance LCVA).Although the lenses increased the aberrations,such as total aberrations and higher-order aberrations,there were few adverse effects on the distance HCVA,distance LCVA and visual perception after one month of MFSCL Wear.

探讨角膜塑形镜、周边离焦软镜对8~10岁儿童近视控制疗效比较

目的 探究8~10岁儿童使用角膜塑形镜(Ortho-k)和周边离焦软镜(DISCs)对近视防控效果比较。方法 前瞻性非随机临床对照研究。将儿童分为Ortho-k组和DISCs组,观察其在近视防控方面的效果。观察两组患者的等效球镜(SE)及眼轴(AL)变化特点。结果 6月随访:两组的平均SE分别为(-3.30±1.27)D、(-3.09±1.31)D,平均AL分别为(24.83±0.89)mm、(24.75±0.94)mm。1年随访:两组的平均SE分别为(-3.49±1.24)D、(-3.32±1.29)D,平均AL分别为(24.96±0.88)mm、(24.92±0.92)mm。随访中:两组的SE和AL均有所增加,但差异无统计学意义。结论 本研究发现两种近视矫正方式在近视防控中具有相似疗效。

长期持续配戴软性角膜接触镜对近视患者角膜透明度的影响

目的探讨长期持续配戴软性角膜接触镜对角膜透明度的影响。方法采用横断面研究方法,对2018年1月至2020年12月在济南明水眼科医院拟行角膜屈光手术的女性近视患者行角膜光密度检查,按照患者持续配戴角膜接触镜的时间将患者分为配戴≥2年~<5年组、配戴≥5年~<10年组和配戴≥10年组,同期纳入年龄、性别匹配和未配戴角膜接触镜者作为对照组,每组50例50眼。以角膜中心为圆心将受检眼角膜划分为直径范围0~2、2~6、6~10、10~12 mm 4个环区,并按照角膜层次将角膜分为浅层(距角膜前表面≤120μm)、深层(距角膜后表面≤60μm)和中间层(角膜浅、深层之间),均取右眼测量结果纳入研究,比较各组受检眼不同角膜环区各层的角膜光密度值。结果随着角膜接触镜配戴时间的延长,角膜光密度值呈下降趋势。对照组、配戴≥2年~<5年组、配戴≥5年~<10年组和配戴≥10年组受检眼角膜光密度值分别为18.51±1.79、18.25±2.10、18.16±1.89和17.83±1.65,总体比较差异无统计学意义(F=1.152,P=0.329)。各组角膜0~2、2~6和6~10 mm环区浅层光密度值总体比较,差异均无统计学意义(F=2.077、2.080、2.229,均P>0.05)。10~12 mm环区浅层角膜光密度值总体比较,差异有统计学意义(F=5.016,P=0.002),其中配戴≥5年~<10年组浅层角膜光密度值高于对照组和配戴≥2年~<5年组,配戴≥10年组角膜光密度值高于对照组,差异均有统计学意义(均P<0.05)。各组角膜0~2 mm和6~10 mm环区中间层光密度值总体比较,差异均有统计学意义(F=3.808、2.813,均P<0.05),其中配戴≥10年组角膜光密度值低于对照组,差异有统计学意义(P<0.05)。各组角膜0~2、2~6、6~10和10~12 mm环区深层光密度值总体比较,差异均有统计学意义(F=5.485、5.625、3.398、2.775,均P<0.05),其中配戴≥5年~<10年组角膜0~2、2~6和10~12 mm深层角膜光密度值明显低于对照组和配戴≥2年~<5年组,配戴≥5年~<10年组6~10 mm和配戴≥10年组0~2、2~6、6~10 mm深层角膜光密度值明显低于对照组,差异均有统计学意义(均P<0.05)。结论女性持续配戴软性角膜接触镜5年内不影响角膜透明度,持续配戴5年以上会导致周边角膜浅层透明度下降。

水凝胶软性亲水接触镜临床应用及安全性

背景:采用水凝胶材料制作而成的Extra-Care软性亲水接触镜含水量、透氧系数、折射率等指标均已达到国家标准。目的:通过与已上市的同类产品TB软性隐形眼镜对比,评价Extra-Care软性亲水接触镜的有效性和安全性。方法:将135例近视眼志愿者随机分入配戴Extra-Care软性亲水接触镜组(试验组)与配戴TB软性隐形眼镜组(对照组)。所有受试者在入选当天、使用7d、使用30d、使用90d时进行视力清晰程度、视力稳定性、配戴舒适度、镜片中心定位、镜片覆盖、眼部异物感、角巩膜缘充血和角膜点状染色及泪膜破裂时间检查。结果与结论:两组视力清晰程度、视力稳定性、镜片中心定位、镜片覆盖、眼部异物感、角巩膜缘充血和角膜点状染色及泪膜破裂时间差异无显著性意义,但试验组舒适度优于对照组(P<0.05)。表明Extra-Care软性亲水接触镜的临床应用是有效和安全的,并提高了配戴舒适度。

PRK术后应用亲水性软性角膜接触镜的临床观察

目的 观察亲水性软性角膜接触镜在准分子激光屈光性角膜切削术 (PRK)后的临床效果。 方法 将双眼屈光状态基本相同,屈光度为-1 00^-6 00D,进行近视PRK矫正的患者 148例,分为术后戴角膜接触镜 3d与不戴两组。观察记录术后 3d的角膜上皮愈合情况、疼痛程度、角膜上皮下混浊程度。术后平均随访半年。 结果 戴镜组术后2d内角膜上皮完全愈合率为 68%,对照组为 24% (P<0 05 )。戴镜组疼痛 0 5级、1级、2级的发生率分别为 58%、20%、22%,对照组为 0、54%、45% (P<0 05)。戴镜组术后 1、3、6个月的角膜haze发生率分别为 50%、32%、14%,对照组为 83%、70%、35% (P<0 05)。 结论 亲水性软性角膜接触镜可明显减轻PRK术后疼痛等刺激症状,促进角膜上皮愈合,使角膜haze发生减少和程度减轻,表明PRK术后角膜创面覆盖及上皮快速愈合是减轻haze发生的重要条件之一。

不同光学矫正方式对人眼单色波前像差的影响

目的通过测量波前像差,研究不同光学矫正方式(框镜和角膜接触镜)对人眼光学性能的影响。方法使用客观波前像差仪测量29人55只近视眼在5种矫正下的波前像差:裸眼(UC)、硬性透氧性角膜接触镜(硬镜)、软性角膜接触镜(软镜)、框架眼镜(框镜)和框镜等效球镜(等效框镜)。光学矫正镜片为球面设计。采用波前像差的均方根(RMS)值和Zernike像差进行计算。每次测量重复3次,取均值分析。结果硬镜矫正的均方根值最小。与裸眼状态相比,软镜矫正的均方根值增加,而硬镜矫正和框镜矫正的均方根值显著减少(F=11.90,P<0.002;F=4.75,P<0.05)。高阶像差中,戴硬镜矫正的均方根值比裸眼、戴软镜和戴框镜矫正都显著减少(F=6.18,P<0.02;F=20.73,P<0.001;F=25.51,P<0.001),而戴软镜和戴框镜矫正的均方根值比裸眼状态都显著增加(F=4.98,P<0.05;F=7.86,P<0.01)。对于中度散光眼,戴软镜矫正会显著增加裸眼状态的均方根值(F=4.87,P<0.05)。戴软镜会引起高阶Zernike像差显著增加;戴框镜显著减少了2阶散光的Zernike像差,戴硬镜则显著减少2至4阶Zernike像差。结论戴软镜矫正增加高阶像差,戴框镜矫正减少低阶像差,戴硬镜矫正减少整眼像差。对于波前像差小的裸眼,由于光学镜片矫正打破了屈光介质之间波前像差的平衡,眼像差增加。球性软镜和不规则角膜表面间厚度不均的泪液层会使中度散光眼的像差显著增加。戴硬镜、软镜和框镜矫正均显著降低初级球差。

输尿管硬镜联合软镜钬激光碎石术治疗复杂上尿路结石的临床研究

目的探讨输尿管硬镜联合软镜钬激光碎石术治疗复杂上尿路结石的临床效果。方法方便选取2011年5月—2015年6月在该院接受治疗的60例上尿路结石患者作为研究对象。对患者进行随机分组,对照组30例给予输尿管硬镜联合体外碎石术治疗,观察组30例给予硬镜联合软镜钬激光碎石术治疗,对比分析两组患者的碎石成功率、复发率及手术情况。结果经治疗,观察组排石率为96.67%,对照组为70.00%,观察组明显高于对照组;观察组患者碎石成功率为93.33%,对照组为73.33%,观察组显著高于对照组;复发率明显低于对照组,两组间对比差异有统计学意义(P<0.05)。观察组平均手术时间、住院时间、出血量及排石时间均明显少于对照组,比较差异有统计学意义(P<0.01)。结论输尿管硬镜联合软镜钬激光碎石术治疗复杂上尿路结石的效果明显优于硬镜钬激光碎石术,值得临床推广及应用。

角膜接触镜对PRK术后角膜上皮愈合的影响

目的 评价亲水性软性角膜接触镜对PRK术后角膜上皮愈合的影响。方法 对 91例低中度近视病例分为戴镜组 (Ⅰ组 )和包眼组 (Ⅱ组 ) ,观察PRK术后角膜上皮愈合情况、角膜刺激症状及视力。结果 角膜上皮愈合时间 :Ⅰ组平均为 2 37± 0 73天 ,Ⅱ组为 3 96± 1 0 5天 (P <0 .0 5 ) ;48小时内愈合者分别为 92 5 5 %和 80 5 9%。角膜刺激症 :+～ + +者Ⅰ组和Ⅱ组分别为 6 5 96 %和 17 6 5 % ,≥ + + +者分别为 33 86 %和 72 35 %。术后 7天裸眼视力 :≥ 0 .5者两组分别为 98 94%和 98 82 % ,但≥ 1 0者分别为 5 2 13%和 9 41%。

配戴亲水软性角膜接触镜治疗青光眼大疱性角膜病变

目的：评价配戴亲水软性角膜接触镜治疗绝对期青光眼导致的大疱性角膜病变的疗效及安全性。方法：给５６ 例５６ 眼因年老体弱，不能或不愿手术治疗而症状明显的绝对期青光眼大疱性角膜病变患者长期连续配戴软性角膜接触镜治疗，并戴镜滴用抗生素及皮质类固醇眼液。结果：大疱性角膜病变症状在戴镜后１ ～３ 天内明显改善者９８．２％ ，１ 周内均解除者９６．４％ 。有８９．２％ 的病例连续戴镜不取出超过３ 个月，平均８ ．８±１０．２ 个月。仅３２．１％ 的患眼出现角膜新生血管，未见继发感染者。结论：连续配戴亲水软性角膜接触镜能解除绝对期青光眼所致的大疱性角膜病变症状，且安全、简便、易行，尤其适用于不能或不愿接受手术治疗的患者。

评价接触镜除蛋白护理液去蛋白的试验方法

利用人工泪液浸泡镜片．模拟蛋白吸附．采用紫外分光光度计在波长280 nm处测试经护理液洗脱的蛋白质的吸光度, 计算蛋白质含量。测试除蛋白护理液对软性角膜接触镜上的蛋白质沉淀的洗脱效果。结果除蛋白含量的测试结果具有重复性。该试验方法可以对除蛋白护理液的洗脱率效果进行评价,但尚需完善．

Extra-Care软性亲水接触镜临床应用的有效性和安全性

目的评价Extra-Care软性亲水接触镜的有效性和安全性.方法选择135例近视眼志愿者,平均年龄(22.49±1.26)岁,所有志愿者签署知情同意书后按照随机数字表方法随机分为配戴Extra-Care软性亲水接触镜组(A组)和配戴NB软性隐形眼镜组(B组).所有的受试者在入选当天、使用7 d、使用30 d、使用90 d时进行眼部和软性亲水接触,镜检查视力清晰程度、视力稳定性、镜片的中心定位,以及安全性评价指标.结果A组和B组差异无统计学意义(P>0.05).结论Extra-Care软性亲水接触镜的临床应用是有效和安全的.

动态稳定法在环曲面软镜验配中的应用研究

目的观察动态稳定法设计环曲面软镜的临床应用表现，并探讨其旋转量、稳定性的影响因素。方法为191例（191只眼）散光自愿者验配动态稳定法设计环曲面软镜，记录右眼的矫正视力、镜片配适评估、旋转量、稳定性及患者的主观评价、安全性分析。结果（1）动态稳定法设计型环曲面软镜的矫正视力与主觉验光的最佳矫正视力无差异。（2）156只眼（81．68％）中心定位正中，140只眼（83．3％）活动度理想，覆盖度均良好。（3）镜片旋转量以向颞侧偏转0—5°最多，有40只眼（20．94％），镜片稳定性为0—5°者有143只眼（74．87％）。（4）初戴时106人（55．50％）诉有轻至中度异物感，145人（75．92％）诉该镜片容易配戴。（5）随访3个月内未发现明显眼部病变。结论在合理筛选患者的前提下，动态稳定法设计环曲面软镜能为散光患者提供有效、安全、舒适的屈光矫正。

亲水角膜接触镜治疗眼前段术后持续性角膜上皮缺损疗效

目的:探讨高亲水性软性角膜接触镜治疗眼前段术后持续性角膜上皮缺损的效果。方法:回顾性病例分析,回顾2011-01/2013-06我院行眼前段术后出现持续性角膜上皮缺损患者28例28眼。采取常规治疗2wk后角膜上皮持续不愈,予高亲水性软性角膜接触镜,至角膜上皮完全愈合后摘镜,同一软镜持续佩戴不超过3wk,否则需更换新镜。随诊观察6mo,主要观察指标:角膜上皮愈合情况、角膜荧光素钠染色情况及眼部症状改善情况。结果:其中治愈21眼(75.00%),显效5眼(17.86%),有效2眼(7.14%),无无效病例,总有效率100.00%。25例(89.29%)眼部不适症状在2d内基本缓解,3例(10.71%)眼部不适症状在1wk内缓解;6例(21.43%)在佩戴3wk内上皮愈合,13例(46.43%)在佩戴6wk内愈合,7例(25.00%)在佩戴9wk内修复,2例(7.14%)佩戴超过12wk,角膜上皮较前修复。均无继发感染迹象。观察6mo无明显复发迹象。结论:高亲水性软性角膜接触镜能明显促进眼前段术后持续性角膜上皮缺损的修复,同时迅速有效缓解各种伴随的眼部刺激症状。

输尿管软镜手术前患者留置双J管期间的居家管理

目的对拟行输尿管软镜手术前留置双J管居家休养患者进行护理干预。方法通过成立专业小组和建立管理档案,对患者在离院前后进行评估和健康教育,掌握患者遵医行为,对其实施规范居家管理。结果患者居家休养和住院治疗得到同样的护理管理,保证患者安全。结论弥补了患者居家休养期间的护理缺失,保证患者能按预期接受手术。

亲水性软性角膜接触镜在眼外伤治疗中的应用

目的 :探讨治疗性亲水性软性角膜接触镜的适应证与效果。方法 :对眼部化学烧伤与热烧伤所致的上皮缺损 33例 34眼、手术创伤等原因导致的大泡性角膜病变 30例以及角膜上皮剥脱 6例 7眼 ,角膜创口缝线刺激者 15例 15眼 ,及角膜小裂孔伤 2例 2眼等患者 ,用连续配戴治疗性亲水性软性角膜接触镜治疗 ,联用抗生素眼药水、人工泪液和爱丽眼药水治疗。结果 :化学与热烧伤后上皮缺损戴镜后治愈率为 82 .4% ;白内障手术创伤等因素影响 ,导致内皮失代偿引起大泡性角膜病变 ,症状缓解率达 10 0 % ;7例机械性外伤所致角膜上皮擦伤和反复性角膜上皮剥脱治愈率 10 0 % ;用于缓解创口缝线的刺激和促进角膜小穿孔等处理也有明显效果。结论 :连续戴用亲水性软性角膜接触镜对大泡性角膜病变引起的疼痛及缝线刺激可消除或缓解 ,对化学烧伤、壬烧伤及机械性外伤角膜上皮缺损及角膜小穿孔也具有促进愈合的效果。