斜视患者术后佩戴角膜绷带镜的临床观察

目的 研究角膜绷带镜(CBL)在斜视术后应用对患者眼表及术后并发症的影响。 方法 选取2016年7月至2017年7月手术治疗的斜视患者60例,分为绷带镜组30例(30眼),对照组30例(30眼)。绷带镜组行斜视矫正术后立即佩戴CBL,对照组单纯行斜视矫正术。观察两组患者术后1、2、7、14 d疼痛程度,眼表刺激程度及角膜干凹斑(CD)和结膜肉芽肿(CG)的发生率。观察两组患者术后7、14 d角膜荧光素染色评分(CFSS)及泪膜破裂时间(BUT)情况。 结果 绷带镜组较对照组在术后1、2 d疼痛程度和眼表刺激程度显著减轻,差异有统计学意义,术后7、14 d疼痛程度和眼表刺激程度无统计学意义,对照组较绷带镜组术后7 d CFSS阳性率升高,术后7、14 d BUT缩短,差异有统计学意义,两组术后14 d CFSS无统计学意义。对照组术后7 d有2例发生CD,术后14 d有1例发生CG,绷带镜组未发生CD和CG。 结论 斜视术后佩戴CBL可显著减轻患者术后疼痛及眼表刺激程度,在术后早期可减轻干眼症状,可减少CD及CG等斜视术后并发症的发生,增强患者术后舒适性及满意度。

Effects of using corneal bandage lens on the cornea after strabismus surgery

Objective To investigate the use of corneal bandage lens(CBL)on postoperative complications after strabismus surgery. Methods Randomized This randomized pilot study involved 60(60 eyes)patients requiring strabismus surgery, who were randomly divided into two groups: CBL(30 patients, 30 eyes)and control(30 patients, 30 eyes). The CBL group was treated with CBL after strabismus surgery, whereas the control group was treated with strabismus surgery alone. The pain, ocular surface irritation symptom, corneal dellen(CD), and conjunctival granuloma(CG)scores at postoperative days 1, 2, 7, and 14 were observed and analyzed. Tear break-up time(BUT)and corneal fluorescein staining score(CFSS)at postoperative days 7 and 14 were also observed and analyzed. Results Pain and ocular surface irritation symptom scores at postoperative days 1 and 2 were significantly lower in the CBL group than in the control group, with no statistically significant difference at postoperative days 7 and 14. CFSS was evidently reduced at postoperative day 7 and BUT was significantly increased at postoperative days 7 and 14 compared with those of the control group, but CFSS had no statistically significant difference at postoperative day 14. Postoperative complications included two cases of CD at postoperative day 7 and one case of CG at postoperative day 14 in the control group, while these postoperative complications were not observed in the CBL group. Conclusion The use of CBL after strabismus surgery significantly relieved postoperative pain and irritation ocular surface, decreased CD and CG postoperative complications, relieved the symptoms and signs of dry eyes, and finally improved patients’comfort and satisfaction.