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目的探讨亲水性软性角膜接触镜治疗内眼术后各种角膜上皮病变的疗效和安全性。设计回顾性病例分析。研究对象36例(36眼)各种内眼手术后角膜上皮病变迁延不愈的患者,其中大泡性角膜病变5例,非大泡性角膜病变31例。方法对上述患者适当处理角膜病灶后,配戴软性角膜接触镜,并调整跟部用药,一旦角膜上皮愈合即摘除软镜;同一软镜持续配戴不得超过3周,否则更换新软镜。随诊6个月观察患者角膜愈合情况。主要指标角膜上皮愈合、刺激症状缓解及并发症情况。结果35例(97.22%)患者眼部刺激症状在3天内明显好转。至随诊6个月,30例(83.33%)完全缓解,6例(16.67%)明显缓解;30例(86.11%)视力明显提高。全部患者未出现继发感染等并发症,非大泡性角膜病变的患者在3周内角膜病变痊愈、症状消失,摘除软镜;大泡性角膜病变患者中3例10周内摘除软镜,2例观察至6个月仍需配戴。结论亲水性软性角膜接触镜促进内眼术后各种角膜上皮病变愈合的效果显著,同时有效缓解各种伴随的眼部刺激症状,是安全有效的辅助治疗方法。
Objective To investigate the efficacy and safety of hydrophilic soft contact lens in treating various corneal epithelial lesions after endoscopic surgery. Design retrospective case analysis. Thirty-six patients (36 eyes) were enrolled in this study. Among them, 5 cases were bullous keratopathy and 31 cases were non-bullous keratopathy. Methods The patients were treated with corneal focal lesion, wear soft contact lenses, and adjust the heel medication, once the corneal epithelium healed soft lens removal; the same soft-lens wear should not exceed 3 weeks, or replace the new soft mirror. Followed up for 6 months to observe the patient’s corneal healing. The main indicators of corneal epithelial healing, irritation and complications to alleviate the situation. Results The eye irritation symptoms of 35 patients (97.22%) were obviously improved within 3 days. Six months (16.67%) were relieved to 30 cases (83.33%), while visual acuity was improved in 30 cases (86.11%). All patients did not appear complications such as secondary infection, non-bullous keratopathy in patients with corneal lesions within 3 weeks of recovery, the symptoms disappear, removal of soft lens; bullous keratopathy in 3 patients within 10 weeks of removal of soft lens, 2 cases still need to wear to observe until 6 months. Conclusions Hydrophilic soft contact lenses can promote the healing of various corneal epithelial lesions after endoscopic surgery and at the same time effectively relieve various concomitant symptoms of ocular irritation. It is a safe and effective adjuvant therapy.