穿透性角膜移植术后持续戴角膜接触镜的临床观察

目的探讨穿透性角膜移植术（penetrating keratop lasty，PKP）后佩戴软性角膜接触镜来减轻术眼刺激症状、促进角膜上皮愈合的临床疗效。方法共201例（201只眼）PKP病例，其中术后戴软性亲水性角膜接触镜者159只眼，未戴镜者42只眼。定期观察患眼角膜知觉、角膜上皮愈合、新生血管形成、角膜内皮数量和形态。随访期6个月。结果术后4个月，戴镜组角膜知觉减退（P〈0.01），摘除镜片后1个月角膜知觉可恢复到同不戴镜组相似；戴镜组会更易形成表层植片新生血管，摘除镜片后1个月新生血管大部分消退；戴镜组角膜上皮完整性较未戴镜组好，上皮修复迅速，不易损伤。角膜内皮细胞的形态和数量两组间无明显区别（均P〉0.05）。结论PKP术后佩戴软性角膜接触镜可减轻术后早期刺激症状、保护角膜，加快上皮愈合。

Clinical effects of continuous corneal contact lens wearing after penetrating keratoplasty

Objective To evaluate the clinical effects of continuous corneal contact lens wearing on eye irritation symptom and corneal epithelization after penetrating keratoplasty （PKP）. Methods Two hundreds and one eyes of 201 patients after PKP were randomly allocated into two groups ： contact lens wearing group （159 eyes） and control group （42 eyes）. The corneal sensitivity, corneal epithelization, neovascularization, endothelial cells density and morphology were observed and followed up for 6 months. Results Four months after PKP, the corneal sensitivity decreased in the contact lens wearing group （P 〈0.01 ）, and could recover to nearly normal level 1 month after contact lens were taken off. Superficial graft neovascularization easily appeared in the contact lens wearing group, but the neovessels tended to regress 1 month after contact lens were taken off. The integrity of epithelium was better in contact lens wearing group than that in control group. The density and morphology of corneal endothelial cells remained same between two groups （P 〉 0.05 ）. Conclusion Continuous corneal contact lens wearing after PKP could palliate irritation, protect corneal epithelium and promote corneal epithelization.