亲水角膜接触镜治疗眼前段术后持续性角膜上皮缺损疗效

Efficacy of highly hydrophilic soft contact lenses for persistent corneal epithelial defects after anterior segment surgery

摘要:

目的：探讨高亲水性软性角膜接触镜治疗眼前段术后持续性角膜上皮缺损的效果。

方法：回顾性病例分析，回顾2011-01/2013-06我院行眼前段术后出现持续性角膜上皮缺损患者28例28眼。采取常规治疗2wk后角膜上皮持续不愈，予高亲水性软性角膜接触镜，至角膜上皮完全愈合后摘镜，同一软镜持续佩戴不超过3wk，否则需更换新镜。随诊观察6mo，主要观察指标：角膜上皮愈合情况、角膜荧光素钠染色情况及眼部症状改善情况。

结果：其中治愈21眼(75.00%)，显效5眼(17.86%)，有效2眼(7.14%)，无无效病例，总有效率100.00%。25例(89.29%)眼部不适症状在2d内基本缓解，3例(10.71%)眼部不适症状在1wk内缓解； 6例(21.43%)在佩戴3wk内上皮愈合，13例(46.43%)在佩戴6wk内愈合，7例(25.00%)在佩戴9wk内修复，2例(7.14%)佩戴超过12wk，角膜上皮较前修复。均无继发感染迹象。观察6mo无明显复发迹象。

结论：高亲水性软性角膜接触镜能明显促进眼前段术后持续性角膜上皮缺损的修复，同时迅速有效缓解各种伴随的眼部刺激症状。

Abstract:

AIM:To investigate the efficacy of highly hydrophilic soft contact lenses for persistent corneal epithelial defects.

METHODS:In this retrospective case analysis, 28 patients(28 eyes)with persistent corneal epithelial defects after anterior segment surgery from January 2011 to June 2013 in our hospital were reviewed. After regular treatment for at least 2wk, the persistent corneal epithelial defects were treated with highly hydrophilic soft contact lenses, until the corneal epithelial healing. Continued to wear the same lens no more than 3wk, or in need of replacement the new one. All cases were followed up for 6mo. Key indicators of corneal epithelial healling, corneal fluorescein staining and ocular symptoms improvement were observed.

RESULTS: Twenty-one eyes were cured(75.00%), markedly effective in 5 eyes(17.86%), effective in 2 eyes(7.14%), no invalid cases, the total efficiency of 100.00%. Ocular symptoms of 25 cases(89.29%)relieved within 2d, the rest 3 cases(10.71%)relieved within 1wk. The corneal epithelial of 6 cases(21.43%)repaired in 3wk, 13 cases(46.43%)in 6wk, 7 cases(25.00%)in 9wk, 2 cases(7.14%)over 12wk. There were no signs of secondary infection. And no evidence of recurrence in 6mo.

CONCLUSION: Highly hydrophilic soft contact lenses could repair persistent corneal epithelial defects after anterior segment surgery significantly, while quickly and effectively relieve a variety of ocular irritation.