两种硅水凝胶角膜接触镜在近视患者LASIK术后早期应用的比较研究

目的比较近视患者接受准分子激光原位角膜磨镶术(LASIK)术后早期佩戴2种硅水凝胶角膜接触镜的上皮修复、术后并发症及眼部不适症状。方法前瞻性选取2019年4月至10月于首都医科大学附属北京友谊医院行LASIK手术的近视患者35例(70眼),采用自身对照,LASIK术后随机给予35眼配戴Lotrafilcon A角膜接触镜,对侧眼配戴Balafilcon A角膜接触镜。术后1 d取出,分别记录术后1、3、7 d的不适症状(疼痛感、干涩和流泪)发生率、术后并发症发生率及角膜荧光素染色(FL)阳性率。对双眼间各项指标进行统计学分析。结果在术后1 d,Lotrafilcon A组无症状率高于Balafilcon A组(77.14%vs.54.29%),差异有统计学意义(P <0.05),在术后3、7 d组间无症状率比较,差异无统计学意义(85.71%vs.80.00%,88.57%vs.91.43%)。Lotrafilcon A组与Balafilcon A组的术后角膜瓣移位皱褶、角膜瓣边缘瘢痕、层间炎症反应等并发症发生率比较(2.86%vs.0,2.86%vs.8.57%,2.86%vs.0),差异无统计学意义(P> 0.05)。在术后1 d,Lotrafilcon A组FL阳性率低于Balafilcon A组(17.14%vs.40.00%),差异有统计学意义(P <0.05),在术后3、7 d组间FL阳性率比较(11.43%vs.14.29%,5.71%vs.8.57%),差异无统计学意义(P>0.05)。结论硅水凝胶角膜接触镜对于缓解眼表刺激症状、促进角膜愈合有显著疗效,适宜于近视患者LASIK术后早期配戴。Lotrafilcon A以及Balafilcon A角膜接触镜在LASIK术后应用是安全有效的,Lotrafilcon A更有助于角膜上皮再生。

Comparative study of two silicone hydrogel contact lenses in myopia patients immediately after LASIK

Objective To compare postoperative epithelial healing time,complications and ocular discomfort symptoms in myopia patients wearing two types of silicon hydrogel contact lenses following laser in situ keratomileusis(LASIK) immediately.Methods Thirty-five patients(70 eyes) who planned to undergo LASIK in Beijing Friendship Hospital,Capital Medical University from April to October 2019 were enrolled prospectively in this study.Every patient randomly received one Lotrafilcon A contact lens in one eye and one Balafilcon A contact lens in the fellow eye immediately after LASIK.The contact lenses were removed in the next day.The frequency of discomfort symptoms of the eyes(foreign body sensation,dry eyes and tearing),frequency of postoperative complications and fluorescein staining(FL) were assessed 1,3 and 7 day after operation.All indexs were compared between the two groups.Results The postoperative asymptomatic rate of the Lotrafilcon A group were higher on 1 day compared to Balafilcon A group(77.14% vs.54.29%),there was significant difference between two groups(P < 0.05),but there was no significant difference by 3 day and 7 day postoperatively(85.71% vs.80.00%,88.57% vs.91.43%).The incidence of complications such as postoperative corneal flap displacement wrinkles,corneal flap marginal scars,and interlaminar inflammation in the Lotrafilcon A group and Balafilcon A group was compared(2.86% vs.0,2.86% vs.8.57%,2.86% vs.0),the difference was not statistically significant(P > 0.05).The fluorescein staining of Lotrafilcon A group showed improvement on 1 day postoperatively comparing with Balafilcon A group(17.14% vs.40.00%),there was significant difference between two groups(P < 0.05),but there was no statistically significant difference by 3 day and 7 day afterwards(11.43% vs.14.29%,5.71% vs.8.57%,P > 0.05).Conclusion Silicone hydrogel contact lenses exhibit prominent efficiency in alleviating the symptoms of ocular surface irritation and promoting corneal healing,the lens is suitable for myopia patients applied immediately after LASIK.Both the Lotrafilcon A and Balafilcon A are safe and effective when applied after LASIK.The former is better than the latter in epithelial regeneration.