摘要
目的探讨角膜接触镜对翼状胬肉患者术后角膜损伤修复的影响。方法选取2016年3月～2018年3月北京市大兴区人民医院眼科门诊就诊的复发性翼状胬肉患者52例的54眼,并将其随机分为A组(28眼)和B组(26眼)。两组均行翼状胬肉切除术,取带部分角膜缘干细胞的结膜瓣,缝合于手术区巩膜表面。A组术后用角膜接触镜治疗5 d,B组常规遮盖。观察患者术后角膜刺激症状、角膜伤口愈合情况及干眼症的发生情况。结果术后第1天,两组角膜刺激性症状评分包括眼痛、异物感、畏光、流泪比较,差异有统计学意义(P <0.05);术后第3、5天,两组角膜刺激症状评分比较,差异无统计学意义(P> 0.05)。两组眼痛、异物感、畏光、流泪等角膜刺激症状评分均随术后时间延长而降低。术后第1天,两组角膜上皮愈合率比较,差异有统计学意义(P <0.05),且A组角膜上皮愈合率明显高于B组(P <0.05);两组第3、5天的角膜上皮愈合率比较,差异无统计学意义(P>0.05);两组术后第1、3、5天的角膜上皮愈合率比较,差异均有统计学意义(P <0.05)。两组术前主观症状评分、角膜荧光染色(FL)评分、泪膜破裂时间(BUT)、基础泪液分泌试验(SIt)比较,差异无统计学意义(P> 0.05)。两组术后主观症状评分、FL、BUT比较,差异有统计学意义(P <0.05),且B组高于或长于A组。与术前比较,两组术后主观症状评分、FL、BUT、SIt差异均有统计学意义(P <0.05),且术后高于或长于术前。结论角膜接触镜能明显改善翼状胬肉患者术后的角膜刺激症状,促进角膜损伤的修复,减轻患者术后的不适。
Objective To investigate the effect of contact lens on the repair of corneal injury in patients with pterygium.Methods A total of 54 eyes of 52 patients with recurrent pterygium who were treated in the Outpatient Department of People′s Hospital of Beijing Daxing District from March 2016 to March 2018 were randomly divided into group A(28 eyes)and group B(26 eyes).The pterygium resection was performed in both groups,and the conjunctival flap with some limbal stem cells was taken and sutured on the sclera surface of the operation area.Group A was treated with contact lens for 5 days,and group B was routinely covered.The postoperative corneal irritation,corneal wound healing and dry eye syndrome were observed.Results On the first day after operation,the scores of corneal irritation symptoms in the two groups included eye pain,foreign body sensation,photophobia and tears,with significant difference(P<0.05);on the third and fifth day after operation,there was no significant difference in the scores of corneal irritation symptoms between the two groups(P>0.05).The scores of corneal irritation symptoms such as eye pain,foreign body sensation,photophobia and tear in both groups decreased with the prolongation of postoperative time.On the first day after operation,the corneal epithelial healing rate of the two groups had significant difference(P<0.05),and the corneal epithelial healing rate of group A was significantly higher than that of group B(P<0.05);the corneal epithelial healing rate of the two groups on the third and fifth day had no significant difference(P>0.05);the corneal epithelial healing rate of the two groups on the first,third and fifth day after operation had significant difference(P<0.05).There was no significant difference in subjective symptom score,corneal fluorescence staining(FL),tear break-up time(BUT)and Schirmer I test(SIt)between the two groups(P>0.05).There were significant differences in subjective symptom score,FL and BUT between the two groups(P<0.05),and group B were higher or longer than group A.Compared with preoperation,there were significant differences in subjective symptom score,FL,BUT and SIt between the two groups(P<0.05),and postoperative were higher or longer than preoperative.Conclusion Contact lens can significantly improve the corneal irritation sympotoms after operation in patients with pterygium,promote the repair of corneal injury and reduce postoperative discomfort.
作者
张茉莉
陈云珍
杜树波
ZHANG Moli;CHEN Yunzhen;DU Shubo(Department of Ophthalmology, People′s Hospital of Beijing Daxing District, Beijing 102600, China)
出处
《中国医药导报》
CAS
2019年第12期97-100,共4页
China Medical Herald
基金
北京市大兴区人民医院科研课题项目(4201609146)
