绷带型角膜接触镜在翼状胬肉手术中应用的临床观察

摘要

Objective:To assessed the effectiveness and security of bandag type corneal contact lens applied in pterygium excision.Method:The prospective case-control study was used in the patients of pterygium.The 40 patients(40 eyes)who were received the pterygium excision were observed from March 2014 to June and randomly divided into two groups:observation group and control group,20 cases in each group(20 eyes).Observation group were wore the bandag type corneal contact lens after surgery and taked it down at 5 d.The control group did not.The degree of pain after surgery were evaluated at 2 h,1,2,3 and 5 d after surgery,meanwhile,corneal epithelium was evaluated by fluorescein vital staining.Result:There are no significant differences between the observation and control group in the percentage of age and gender and size of the pterygium(P>0.05).After surgery,the degree of pain at 2 h,1,2,3 and 5 d were as following:the score of observation group were(0.92±0.47)scores,(0.58±0.45)scores,(0.34±0.42)scores, (0.19±0.31)scores,(0.10±0.27)scores; the score of control group were(3.11±0.75)scores,(1.98±0.43) scores,(1.59±0.66)scores,(0.83±0.52)scores,(0.43±0.27)scores.The degree of pain of treatment group was significantly decreased compared to control group,the difference was statistically significant(P<0.01).After surgery at 5 d,the score of corneal epithelium stained with fluorescein between of observation group(0.76±1.31)and control group (1.28±1.45),the difference was statistically significant(P<0.05).Follow-up was 2-6 months,no complications,such as infection,relapse,implant healing badness and subconjunctival cyst.Conclusion:The bandag type corneal contact lens could markedly release pain response after pterygium excision surgery,promote postoperative recovery,which is beneficial to reduce the postoperative recurrence rate and improve the postoperative quality of life.%目的：探讨绷带型角膜接触镜应用于翼状胬肉切除术的有效性及安全性。方法：采用前瞻性对照病例研究，观察2014年3-6月接受翼状胬肉切除术的患者40例（40眼），随机分为观察组和对照组两组，每组20例（20眼）。观察组在手术结束时角结膜表面配戴绷带型角膜接触镜，术后5 d取下绷带型角膜接触镜，对照组不做任何处理。比较术后2h及1、2、3、5d两组患者疼痛程度、术后5d角膜上皮荧光素染色评分。结果：选取的两组患者在年龄、性别比例及翼状胬肉大小方面的差异均无统计学意义（P>0.05）。术后2 h及1、2、3、5 d时两组患者疼痛程度评分：观察组分别为（0.92±0.47）分、（0.58±0.45）分、（0.34±0.42）分、（0.19±0.31）分、（0.10±0.27）分，对照组分别为（3.11±0.75）分、（1.98±0.43）分、（1.59±0.66）分、（0.83±0.52）分、（0.43±0.27）分，观察组患者疼痛程度评分均较对照组显著降低，两组比较差异有统计学意义（P<0.01）。术后5 d角膜上皮荧光素染色评分观察组为（0.76±1.31）分，对照组为（1.28±1.45）分，两组间差异无统计学意义（P>0.05）。随诊2~6个月未见感染、复发、植片愈合不良、结膜下囊肿等并发症发生。结论：翼状胬肉术后应用绷带型角膜接触镜，缓解了患者疼痛和刺激症状，促进术后恢复，有利于降低术后复发率，改善术后生活质量。