角膜绷带镜在生物工程角膜移植术后应用的效果和安全性研究  

Role and safety of corneal bandage lens in keratoplasty with bioengineered cornea

作　　者：黎彦宏[1] 桑可欣[1] 王小东[1] LI Yan-hong;SANG Ke-xin;WANG Xiao-dong(Department of Ophthalmology,Xi'an No.1 Hospital/Shaanxi Institute of Ophthalmology/the First Affiliated Hospital of Northwestern University,Xi'an 710002,Shaanxi,CHINA)

机构地区：[1]西安市第一医院眼科陕西省眼科研究所西北大学附属第一医院眼科,陕西西安710002

出　　处：《海南医学》2020年第16期2108-2111,共4页Hainan Medical Journal

摘　　要：目的研究角膜绷带镜在生物工程角膜移植术后应用的临床效果和安全性。方法收集2017年3月至2019年6月于西安市第一医院眼科行生物工程角膜移植术的感染性角膜溃疡患者共42例42眼,按随机数表法分为对照组和观察组各21例21眼。两组患者术后持续包眼至角膜植片完全上皮化,观察组在角膜上皮化后佩戴角膜绷带镜,对照组在上皮化后开放点眼。分别于角膜上皮化后0 d、1周、1个月、3个月和6个月时评估所有患者眼表刺激症状评分、结膜充血情况评分、角膜荧光素染色评分,进行泪膜破裂时间(BUT)测定,统计植片存活率和并发症发生情况。结果观察组患者在角膜上皮化后的0 d、1周、1个月、3个月、6个月的眼表刺激症状评分分别为(4.76±1.23)分、(4.38±1.20)分、(4.42±1.22)分、(4.53±1.18)分、(4.73±0.88)分,对照组分别为(11.48±2.80)分、(5.76±1.87)分、(5.11±1.37)分、(5.27±1.34)分、(5.20±0.94)分,两组患者在0 d和1周时的评分比较差异均有统计学意义(P<0.05),但1个月、3个月和6个月时的评分比较差异均无统计学意义(P>0.05);两组患者的结膜充血程度评分在各个时间点均比较接近,差异无统计学意义(P>0.05);在角膜上皮化后1周、1个月、3个月时,观察组患者的角膜荧光素染色评分明显低于对照组,差异均有统计学意义(P<0.05),但上皮化后0 d和6个月时,两组患者的评分比较差异均无统计学意义(P>0.05);观察组患者的BUT在0 d、1周、1个月、3个月、6个月时分别为(6.52±1.75)s、(7.90±1.22)s、(8.00±1.00)s、(8.18±0.64)s、(8.27±0.88)s,对照组分别分别为(6.76±1.41)s、(7.10±0.83)s、(7.32±0.82)s、(7.56±0.73)s、(8.07±0.80)s,上皮化后1周、1个月、3个月时的BUT比较差异均有统计学意义(P<0.05),但0 d和6个月时的BUT比较差异均无统计学意义(P>0.05);至上皮化后6个月时,观察组和对照组患者的植片成活率分别为71.43%、66.67%,差异Objective To study the clinical effect and safety of corneal bandage lens after keratoplasty with bioengineered cornea.Methods The clinical data of 42 cases(42 eyes)of infection corneal ulcer treated by lamellar keratoplasty with bioengineered cornea at Xi'an First Hospital from March 2017 to June 2019 were collected.The patients were divided into the observation group(n=21)and control group(n=21)according to random number table method.The patients in the observation group wore corneal bandage lens after corneal epithelial healing.The patients in the control group did not wear corneal bandage lens.All the patients were examined and evaluated at 0 d,1 week,1 month,3 months and 6 months after corneal epithelium formation.The evaluated indicators included ocular surface irritation symptoms score,conjunctival hyperemia score,corneal fluorescein staining score,the tear film break-up time(BUT)measurement,graft survival rate and complications.Results In the observation group,the ocular surface irritation symptoms of 0 d,1 week,1 month,3 months,6 months after corneal epithelization were(4.76±1.23)points,(4.38±1.20)points,(4.42±1.22)points,(4.53±1.18)points,(4.73±0.88)points,respectively,and in the control group,the scores were(11.48±2.80)points,(5.76±1.87)points,(5.11±1.37)points,(5.27±1.34)points,(5.20±0.94)points,respectively.The scores of 0 d and 1 week were significantly different(P<0.05)and there was no statistical difference in the scores at 1 month,3 months and 6 months(all P>0.05).The conjunctival congestion in the observation group were similar as the control group and there was no significant difference at each time point(P>0.05).The corneal fluorescein staining scores of the observation group at 1 week,1 month and 3 months were significantly lower than those of the control group(P<0.05),while there were no significant difference at 0 d and 6 months(P>0.05).BUT in the observation group were(6.52±1.75)seconds,(7.90±1.22)seconds,(8.00±1.00)seconds,(8.18±0.64)seconds,(8.27±0.88)seconds at 0 d,1 week

关 键 词：生物工程角膜 角膜绷带镜 角膜上皮 感染复发 泪膜破裂时间 角膜溃疡 

分 类 号：R779[医药卫生—眼科]