绷带式角膜接触镜对翼状胬肉患者角膜屈光状态及术后并发症的影响

目的:分析绷带式角膜接触镜对翼状胬肉患者角膜屈光状态及术后并发症的影响。方法:前瞻性对照研究。将2018-01/2019-12拟在本院行翼状胬肉扩大切除联合自体角膜缘干细胞移植术的翼状胬肉患者116例116眼。按随机数字表法分两组:对照组58眼行翼状胬肉扩大切除联合自体角膜缘干细胞移植术,观察组58眼在对照组基础上联合绷带式角膜接触镜治疗。比较两组患者术后最佳矫正视力(BCVA)、角膜地形图表面不对称指数(SAI)、表面规则指数(SRI)、角膜屈光状态及术后并发症。结果:两组患者术后1、3mo时BCVA均较术前显著改善(P<0.05),但组间无差异(P>0.05);两组患者术后1、3mo时的角膜水平曲度、角膜垂直曲度较术前均显著上升,角膜散光度较术前显著下降,且观察组术后1、3mo时的角膜散光度显著低于对照组(P<0.05);两组患者术后1、3mo SAI、SRI较术前均显著下降,且观察组SAI、SRI显著低于对照组(P<0.05);两组患者术后随访期间均未见感染、植片愈合不良、结膜下囊肿等并发症发生,但观察组眼部刺激症状发生率显著低于对照组,两组患者术后2wk时眼部刺激症状发生率较术前1wk时均有下降,且观察组术后2wk时的眼部刺激症状发生率显著低于对照组(P<0.05)。结论:翼状胬肉扩大切除联合自体角膜缘干细胞移植术及绷带式角膜接触镜更利于翼状胬肉患者角膜屈光改善,并能降低眼部刺激症状发生率。

Influence of bandage contact lens on corneal refractive status and postoperative complications in patients with pterygium

AIM: To analyze the influence of bandage contact lens on corneal refractive status and postoperative complications in patients with pterygium.

METHODS: Totally 116 patients with pterygium treated in the hospital between January 2018 and December 2019 were recruited in the study. They were divided into control group and observation group by random number table method, 58 cases in each group. The control group received extended pterygium resection and autologous corneal limbal stem cell transplantation. On this basis, the observation group was treated with bandage contact lens. The best corrected visual acuity(BCVA), surface asymmetry index(SAI)of corneal topography, surface regularity index(SRI), corneal refractive power and postoperative complications in the two groups were compared.

RESULTS: Compared with preoperation, the BCVA of the two groups was significantly higher 1mo and 3mo after operation(P<0.05), without statistically significant difference between the groups(P>0.05). Corneal horizontal and vertical curvature of the two groups were significantly higher, while corneal astigmatism was significantly lower at 1mo and 3mo after surgery. Meanwhile, the observation group had significantly lower corneal astigmatism than the control group(P<0.05). SAI and SRI of the two groups significantly decreased, which were significantly lower in the observation group than in the control group(P<0.05). No complications such as infection, poor healing of grafts and subconjunctival cysts were observed. The incidence of eye irritation was significantly lower in the observation group than in the control group, and lower at 2wk than at 1wk before operation(P<0.05).

CONCLUSION: Extended pterygium resection combined with autologous corneal limbal stem cell transplantation and bandage contact lens is more conductive to the improvement of corneal refraction in patients with pterygium, which also can reduce the incidence of eye irritation.