超声乳化术后早期应用硅水凝胶角膜接触镜的临床效果观察

发布时间：2018-11-07 09:22

【摘要】：目的探讨超声乳化术患者术后早期应用硅水凝胶角膜接触镜的临床效果。方法选择年龄相关性白内障患者常规行3.0 mm透明角膜隧道切口超声乳化术,术毕时随机分为2组:戴镜组(106例145眼)和敷料组(110例159眼)。戴镜组术毕时予硅水凝胶角膜接触镜置入结膜囊,术后1 h立即开始予抗炎眼液和人工泪液滴眼(1次·h-1至睡前),并于术后1 d取出;敷料组术毕时予常规敷料包眼。观察术前及术后1 d、1周、1个月的裸眼视力、最佳矫正视力、泪膜破裂时间(break-up time,BUT)、基础泪液分泌量、主观症状评分、眼前节体征(包括角膜水肿、角膜后沉着物、房水闪辉)评分以及白内障术后相关并发症。结果戴镜组在术后1 d的裸眼视力、最佳矫正视力分别为4.80±0.15和4.82±0.20,均高于敷料组,差异均有统计学意义(均为P0.05);而在术后1周、1个月2组间差异无统计学意义(均为P0.05)。戴镜组在术后1 d BUT为(5.27±3.59)s,而敷料组为(3.37±2.61)s,差异有统计学意义(P0.05),2组术后各时间点均比术前缩短。2组间基础泪液分泌量在术后各个时间点差异均无统计学意义(均为P0.05);术后1 d较术前增加,术后1周、1个月均较术前减少。主观症状和眼前节体征戴镜组在术后1 d均比敷料组轻,2组在术后各时间点均比术前加重,差异均有统计学意义(均为P0.05)。2组在术后均未发现白内障术后相关并发症。结论超声乳化术后早期配戴硅水凝胶角膜接触镜配合开放滴眼,不仅使患者在术后即刻拥有视力,还可安全、有效减轻早期眼前节炎症,促进泪膜稳定,缓解患者的不适感。
[Abstract]:Objective to investigate the clinical effect of early application of silicone hydrogel contact lens in patients with ultrasonic emulsion. Methods 3. 0 mm transparent corneal tunnel incision phacoemulsification was performed in patients with age-related cataract. At the end of the operation, they were randomly divided into two groups: the group of wearing lens (106 cases, 145 eyes) and the group of dressing (110 cases, 159 eyes). Silicone hydrogel contact lens was placed into the conjunctival sac in the wearing group, and the anti-inflammatory eye drops and artificial tear drops (once h-1 to before bedtime) were given immediately after 1 hour, and were removed on the first day after operation, while the routine dressing was used in the dressing group at 1 hour after operation. The uncorrected visual acuity, best corrected visual acuity (BCVA), tear film rupture time (break-up time,BUT), basic tear secretion, subjective symptom score, anterior segment signs (including corneal edema) were observed before and 1 day after operation. Posterior corneal deposition, aqueous flash) score and postoperative complications. Results the uncorrected visual acuity of the wearing group was 4.80 卤0.15 and 4.82 卤0.20, respectively, which was significantly higher than that of the dressing group (P0.05). However, there was no significant difference between the two groups at 1 week and 1 month after operation (P0.05). The BUT was (5.27 卤3.59) s in the mirror wearing group and (3.37 卤2.61) s in the dressing group. The difference was significant (P0.05). The amount of basal tear secretion in both groups was shorter than that before operation. There was no significant difference between the two groups at each time point (P0.05). 1 day after operation increased compared with preoperative, 1 week after operation, 1 month decreased compared with preoperative. The subjective symptoms and anterior segment signs were lighter in the group of wearing mirror than that in the dressing group on the 1st day after operation, and were more serious in the two groups at each time point after operation than before operation. The difference was statistically significant (P0.05). No postoperative complications were found in both groups. Conclusion early wear of silicone hydrogel contact lens and open eye drop after phacoemulsification not only can make the patients have visual acuity immediately after phacoemulsification, but also can effectively reduce the inflammation of early anterior segment, promote the stability of tear film and relieve the discomfort of the patients.
【作者单位】：四川省医学科学院四川省人民医院;
【分类号】：R779.66

【参考文献】