[1]黄琴,廖洪斐,王耀华,等. 绷带型角膜接触镜在上睑下垂术后早期的应用价值[J].眼科新进展,2015,35(8):769-771.[doi:10.13389/j.cnki.rao.2015.0211]
　HUANG Qin,LIAO Hong-Fei,WANG Yao-Hua,et al. Early postoperative application value of bandage corneal contact lens in ptosis[J].Recent Advances in Ophthalmology,2015,35(8):769-771.[doi:10.13389/j.cnki.rao.2015.0211]
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 绷带型角膜接触镜在上睑下垂术后早期的应用价值
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
35卷
期数:
2015年8期
页码:
769-771
栏目:
应用研究
出版日期:
2015-08-05

文章信息/Info

Title:
 Early postoperative application value of bandage corneal contact lens in ptosis
作者:
 黄琴; 廖洪斐; 王耀华; 胡军华; 杨垂勋
 330006　江西省南昌市，南昌大学附属眼科医院
Author(s):
 HUANG Qin;  LIAO Hong-Fei;  WANG Yao-Hua;  HU Jun-Hua;  YANG Chui-Xun
 Affiliated Eye Hospital of Nanchang University, Nanchang 330006 , Jiangxi Province , China
关键词:
 ; 硅水凝胶角膜接触镜; 上睑下垂; 眼表功能
Keywords:
 ; silicone hydrogel corneal contact lens; ptosis ;  ocular surface function
DOI:
10.13389/j.cnki.rao.2015.0211
文献标志码:
A
摘要:
 目的　探讨上睑下垂术后早期应用绷带型角膜接触镜的临床效果。方法　将先天性上睑下垂矫正术后眼睑闭合不全患者２１例（３２眼）随机分为Ａ组（戴镜组）和Ｂ组（传统组）。２组均按常规方法行额肌肌瓣悬吊术，术后Ａ组均连续配戴绷带型角膜接触镜，每１４ｄ更换１次；Ｂ组均根据传统的方法滴滴眼液和涂眼膏，术前及术后３ｄ、７ｄ、１个月、３个月观察角膜荧光素染色、泪膜破裂时间、泪液分泌试验、患者主觉症状等以评价治疗效果。结果　Ａ组和Ｂ组术后各时间段泪液分泌量均无明显改变，但两组在术后早期均出现了角膜上皮染色，染色点较术前增加，术后３ｄ角膜荧光染色评分明显增加，但两组间差异无统计学意义（Ｐ＝０．６９８）；术后７ｄ、１个月荧光染色评分仍继续增加，且两组间差异有统计学意义（Ｐ＝０．０３２、０．０１０）；术后３个月角膜染色基本消失，两组间差异无统计学意义（Ｐ＝０．５５７）。泪膜破裂时间术前无明显差异，术后３ｄ两组均较术前减少，术后７ｄ、１个月Ａ组较前逐渐变长，Ｂ组变化不明显，两组间差异有统计学意义（Ｐ＝０．０４、０．０２、０．０１），术后３个月两组均有所恢复，组间差异无统计学意义（Ｐ＝０．７４３）。主觉症状评分术前两组间差异无统计学意义（Ｐ＝０．８３６），术后３ｄ患者主觉症状明显增加，但Ａ组症状明显较Ｂ组减轻，两组差异有统计学意义（Ｐ＝０．０３５）；术后７ｄ、１个月两组主觉症状均有所减轻，但两组差异仍有统计学意义（Ｐ＝０．０３１、０．０１７）；术后３个月两组主觉症状逐渐消失，组间差异无统计学意义（Ｐ＝０．６９２）。结论　上睑下垂矫正术后早期配戴硅水凝胶角膜接触镜，不仅可使患者早期用眼，而且可促进患者泪膜稳定，减轻眼部不适感，降低发生暴露性角膜炎的风险。
Abstract:
 Objective To study the clinical effects of early postoperative application of bandage corneal contact lens in ptosis. Methods Congenital ptosis correction in patients with postoperative eyelid closure of 21 cases ( 32 eyes) were randomly divided into group A ( wearing lens group) and group B ( traditional group). Continuous wear dressing mirror, all patients of group A were once every 14 days replacement, group B all cases according to the traditional method received eye drops and eye ointment. The corneal fluorescein staining, break-up time, Schirmer n test and subjective symptoms at preoperative and postoperative 3 days ,7 days , I month were observed by slit lamp to evaluate the effects of the treatment. Results The tear secretion in group A and group B at each postoperative time had no obvious change,but the early postoperative corneal epithelium staining appeared in the two groups, the postoperative staining point is increased, the corneal fluorescein staining score at postoperative 3 days significantly increased.but there was no statistically sigruficant difference between the two groups (P = 0. 698 ) . Fluorescent staining score at postoperative 7 days, I month continued to increase.and the differences between the two groups was statistically sigruficant ( P = 0. 032 , 0. 010 ) . and the corneal stairung basic disappeared at postoperative 3 months.there was no statistically significant difference between the two groups ( P = 0. 557 ) . There was no difference in preoperative tear break-up time between two groups , the postoperative 3 days of two groups all decreased, group A at postoperative 7 days , I month became longer , while group B was not obvious. the difference between the two groups was statistically sigruficant(P = 0. 04 ,0. 02 ,0. 01 ) , and the postoperative 3 months in the two groups were recovered,there was no statistically significant difference between the groups (P = 0. 743 ) . There was no difference in preoperative subjective symptom scores between two groups (P = 0. 836) , the postoperative 3 days increased obviously,but group A was lower than group B (P = 0. 035) . and the postoperative I days and I month of two groups all deceased. but there were statistical differences between two groups (P = 0. 031, 0. 017 ) ; At postoperative 3 months , the subjective symptom in two groups gradually disappeared.there was no statistical difference between two groups (P = 0. 692) . Conclusion Early postoperative wearing silicone hydrogel contact lens in ptosis not only can bring the patients early vision with stable ocular surface .but also can relieve eye discomfort and reduce the risk of exposure keratitis.

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更新日期/Last Update: 2015-07-31