绷带镜在翼状胬肉切除联合结膜瓣移植术后的应用

目的:探讨绷带镜在翼状胬肉切除联合结膜瓣移植术后应用的临床效果.方法:前瞻、随机、对照性病例研究.收集2015-01/2016-01在我院诊断为原发性翼状胬肉拟接受翼状胬肉切除联合结膜瓣移植术患者共110例110眼,奇数者为绷带镜组(在翼状胬肉切除联合结膜瓣移植术后给予配戴绷带镜),偶数组为对照组(仅行翼状胬肉切除联合结膜瓣移植术).术后1、3、7d时采用VAS视觉模拟量表法评估术后疼痛程度,并观察术后患者角膜刺激症状;术后3d采用角膜荧光染色法检测角膜上皮修复情况;随访患者至术后1a,统计翼状胬肉复发情况.结果:术后1d绷带镜组疼痛评分(4.13±2.06分)较对照组(5.80±1.93分)明显减轻(t=4.391,P<0.001);术后3d绷带镜组疼痛评分(2.09±1.36分)较对照组(3.65±1.65分)明显减轻(t=5.422,P<0.001);术后7d绷带镜组和对照组疼痛评分无统计学差异(t=1.295,P=0.198).术后1d和3d时,绷带镜组刺激症状均较对照组减轻(P<0.05),而术后7d时绷带镜组与对照组比较无统计学差异(P=0.052).术后3d时角膜荧光染色面积,绷带镜组(0.33±0.37mm2)较对照组(2.73±2.21mm2)明显减小(t=7.921,P<0.001).术后1a翼状胬肉复发率,绷带镜组与对照组比较无统计学差异(P=1.000).结论:翼状胬肉切除联合结膜瓣移植术后配戴角膜绷带镜可以有效减轻患者术后疼痛和刺激症状,加速角膜上皮愈合,明显提高患者术后舒适度.

Application of bandage contact lens in pterygium excision combined with conjunctival transplantation

AIM: To evaluate the application and effect of bandage contact lens in pterygium excision combined with conjunctival transplantation(CAT).

METHODS: In a prospective, randomized, controlled clinical study, 110 patients(110 eyes)diagnosed with primary pterygium were collected in PLA NO.474 Hospital from January 2015 to January 2016. The 110 patients enrolled in the study in turn, and divided into two groups by the odd and even number. The odd number divided into bandage contact lens group(CAT + bandage contact lens, n=55), while the even number divided into control group(CAT, n=55). Visual analog scale(VAS)and corneal irritation were evaluated on 1, 3 and 7d after operation. Cornea fluorescent staining testing was carried out on 3d after operation. Following-up all the patients with 1a at least observed the recurrence of pterygium.

RESULTS:The score of VAS in bandage contact lens group less than that in control group on 1d(4.13±2.06 vs 5.80±1.93, t=4.391, P<0.001)and 3d(2.09±1.36 vs 3.65±1.65, t=5.422, P<0.001)after operation, while there was no significant difference between two groups on 7d(t=1.295, P=0.198)after operation. The corneal irritation in bandage contact lens group less than that in control group on 1d and 3d after operation(P<0.05), while there was no significant difference between two groups on 7d after operation(P=0.052). Cornea fluorescent staining testing area in bandage contact lens group was less than that in control group on 7d after operation(0.33±0.37mm² vs 2.73±2.21mm², t=7.921, P<0.01). There was no significant difference in recurrence rate between two groups after 1a operation(P=1.000).

CONCLUSION:Bandage contact lens could significantly release pain and corneal irritation, promote the healing of the corneal epitheliums in the defected area, and increase the postoperative comfort level in patients after operation.