绷带型角膜接触镜在翼状胬肉手术中的应用  

Application of bandage contact lens in pterygium surgery

作　　者：李新宇[1] 王娟[1] 徐玲娟[1] 胡军[1] 胡维琨[1] 李贵刚[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院眼科,湖北省武汉市430030

出　　处：《眼科新进展》2013年第8期743-745,共3页Recent Advances in Ophthalmology

基　　金：国家自然科学基金青年基金(编号:81200661);湖北省自然科学基金面上项目(编号:2010CDB09802);武汉市青年科技晨光计划项目(编号:201150431124)~~

摘　　要：目的探讨绷带型角膜接触镜应用于翼状胬肉切除术的有效性及安全性。方法采用前瞻性对照病例研究,观察2012年3月至12月接受翼状胬肉切除联合自体角膜缘干细胞移植术的患者28例(28眼),随机分为2组:绷带型角膜接触镜组和对照组,每组14例(14眼)。绷带型角膜接触镜组在手术结束时角结膜表面配戴绷带型角膜接触镜,术后3d取下绷带型角膜接触镜,对照组不做任何处理。比较术后2h、6h、24h、48h、72h2组患者疼痛程度、术后3d角膜上皮荧光素染色评分及角膜上皮缺损面积的差异,并观察并发症的发生情况。结果 2组患者年龄、性别及翼状胬肉大小差异均无统计学意义(均为P>0.05)。术后2h、6h、24h、48h、72h2组患者疼痛程度评分:绷带型角膜接触镜组分别为(0.79±0.43)分、(0.88±0.53)分、(0.43±0.51)分、(0.29±0.47)分、(0.14±0.36)分,对照组分别为(2.57±0.51)分、(2.57±0.76)分、(1.86±0.66)分、(1.43±0.51)分、(0.86±0.53)分,绷带型角膜接触镜组患者疼痛程度评分均较对照组显著降低(均为P<0.01),术后3d角膜上皮荧光素染色评分对照组为(1.57±1.34)分,绷带型角膜接触镜组为(0.86±1.10)分,2组间差异无统计学意义(P=0.135)。角膜上皮缺损面积:对照组为(2.68±4.33)mm2,绷带型角膜接触镜组为(0.17±0.45)mm2,2组间差异有统计学意义(P=0.041)。随诊2～6个月未见感染、复发、植片愈合不良、结膜下囊肿等并发症发生。结论绷带型角膜接触镜可明显减轻翼状胬肉切除术后疼痛反应,促进角膜上皮愈合。Objective To explore the efficacy and safety of bandage contact lens in pterygium excision surgery. Methods A total of 28 cases （28 eyes） treated with pterygium excision combined with autologous timbal stem cell transplantation surgery from March 2012 to December 2012 were collected by prospective controlled case stud- y, and were randomly and evenly divided into two groups. Patients in bandage contact lens group weared bandage contact lens from the first to third day after surgery, while patients in the control group did not. The degree of pain after surgery were evaluated at 2 hours ,5 hours ,24 hours ,48 hours and 72 hours after surgery, and the healing of corne- al epithelial were assessed by fluorescein staining and differences of the corneal epithe- lial defect areas were obeserved at 3 days after surgery. Results There was no signifi- cant difference between the ages, sexes and pterygium sizes of the two groups （ all P 〉 0. 05）. The pain index scores at 2 hours,5 hours,24 hours,48 hours and 72 hours after surgery： the bandage contact lens group were （0.79 ＋ 0.43 ） scores, （0.88 ＋ 0.53 ） scores, （0.43 _＋ 0.51 ） scores, （0.29 ＋ 0.47 ） scores, and（ 0. 14 _＋ 0.35 ） scores; Control group were （2.57 ＋ 0.51 ） scores, （2.57 ＋ 0.75 ） scores, （ 1.85 ＋_ 0.65 ） scores, （ 1.43 ＋ 0.51 ） scores, and（0.86 ＋ 0.53 ）scores. The pain index scores of the bandage contact lens group were significantly less than those of control group（ all P 〈 0.01 ）. At the third day after surger- y,there was no significant difference in corneal epithelial fluorescein staining scores be- tween the control group （ 1. 57 _＋ 1. 34 ） scores and the bandage contact lens group （0.85 _＋ 1. l0 ）scores （P = 0. 135 ）, while the epithelial defect areas of the bandage con- tact lens group （0.17 ＋ 0.45 ） mm2 was statistically smaller than that of the control group （ 2.68 ＋ 4.33 ） mm2 （P = 0. 041 ）. They were followed up from 2 to 6 months, there were

关 键 词：角膜接触镜 翼状胬肉 疼痛 角膜上皮 

分 类 号：R777.33[医药卫生—眼科]