玻璃酸钠滴眼液联合软性角膜接触镜在翼状胬肉切除术后的早期应用

目的:探讨3g/L玻璃酸钠滴眼液联合软性角膜接触镜对翼状胬肉术后早期角膜上皮愈合及局部舒适度的影响.方法:选取90例90眼原发性单眼翼状胬肉患者,行翼状胬肉切除联合自体角膜缘干细胞移植术,术毕随机将患者分为3组,A组(研究组)术毕立即戴软性角膜接触镜,次日给予3g/L玻璃酸钠滴眼液及左氧氟沙星滴眼液点眼(4次/d),妥布霉素地塞米松眼膏涂眼(1次/晚),术后7d取下角膜接触镜;B组(常规用药组)常规予左氧氟沙星滴眼液点眼(4次/d),妥布霉素地塞米松眼膏涂眼(1次/晚);C组在B组的基础上加用3g/L玻璃酸钠滴眼液(4次/d).观察并比较各组术后角膜上皮愈合时间及不同时间点的眼部疼痛评分情况.结果:A组术后6h,1、3d疼痛评分均低于其余两组,差异有统计学意义(P<0.05);术后5、7d,三组疼痛评分无明显差异(P>0.05).术后第1d,三组均无完全愈合者;术后2d,A组的角膜上皮愈合率显著高于B组(P=0.015),而A组和C组及B组和C组比较,差异均无统计学意义(P>0.05);术后3d,A组的角膜上皮完全愈合率均高于其余两组,差异有统计学意义(P<0.05).结论:翼状胬肉术后早期应用3g/L玻璃酸钠滴眼液联合佩戴软性角膜接触镜可以加快角膜上皮缺损修复,减轻局部疼痛,显著改善患眼局部舒适度.

Evaluation of the early effects of hyaluronate sodium eye drops combined with soft corneal contact lenses after pterygium excision surgeries

AIM: To investigate the early effects of 3g/L sodium hyaluronate eye drops combined with soft contact lenses on corneal epithelial healing and local comfort.

METHODS: Totally 90 patients(90 eyes)with primary monocular pterygium were randomly divided into three groups after pterygium excision surgeries(n=30, for each). Each group received pterygium excision combined with limbal stem cell autograft transplantation. The research group wore soft corneal contact lens for 7d after the surgery, and the next day all of them were given 3g/L sodium hyaluronate and levofloxacin eye drops four times a day, tobrmycin and dexamethasone ophthalmic ointment once every night. The Group B did not wear the corneal contact lens, they were given levofloxacin eye drops four times a day and tobrmycin and dexamethasone ophthalmic ointment once every night. About the Group C, the 3g/L sodium hyaluronate eye drops was added on the basis of conventional medication of Group B. The time of corneal epithelial healing after surgery and the ocular pain score in different times were observed and contrasted.

RESULTS: Mean pain score of Group A were significantly lower than Group B and C at 6h, the first day and the third day after operation(P<0.001), but there was no significant difference between the three groups at the fifth day and the seventh day(P>0.05). The first day after the surgery, there were no eyes of corneal epithelium completely healed, but the complete healing rate of Group A were significantly higher than the other two group at the second day and the third day.(P<0.05).

CONCLUSION: Early use of 3g/L hyaluronate sodium eye drops combined with soft corneal contact lenses after pterygium excision surgeries will not only accelerate corneal epithelial wound healing, but also relieve local pain, improve ocular comfort significantly.