Le Sage N, Verreault R, Rochette L
Research Center, Centre Hospitalier Affilié de l'Université Laval (CHA), Quebec City, Quebec, Canada.
Ann Emerg Med. 2001 Aug;38(2):129-34. doi: 10.1067/mem.2001.115443.
We sought to evaluate the efficacy of eye patching in the treatment of traumatic corneal abrasions in terms of time to healing and reduction in pain and discomfort.
One hundred sixty-three patients presenting at the emergency department of a large university-affiliated hospital with traumatic corneal abrasions were included in this single-blind prospective controlled trial. Eligible patients were assigned to 1 of 2 treatment regimens: topical antibiotic ointment and occlusive patch over the affected eye (n=82) or topical antibiotic ointment 4 times a day without an occlusive patch (n=81). Patients were reexamined every 24 hours until corneal healing occurred. Healing evaluation was performed by the emergency physician, using a slit lamp with fluorescein staining, without knowledge of the patient's assignment to a treatment group. The degree of discomfort was assessed at each visit by using a visual analog scale.
Both treatment groups were similar regarding size of the corneal lesions, delay from trauma to first ED visit, presence of foreign body or siderosis, initial degree of discomfort, and presence of specific symptoms (irritation, foreign body sensation, photophobia, redness, and pain). In the patched group, cumulative incidences of healing were 51%, 78%, and 92% after 1, 2, and 3 days, respectively, compared with 60%, 83%, and 88% in the nonpatched group. In the patched group, symptoms of initial discomfort decreased by 4.8, 4.1, and 5.5 cm after 1, 2, and 3 days, respectively, compared with 3.3, 5.1, and 6.5 cm in the nonpatched group.
Eye patching does not appear to be beneficial in the treatment of traumatic corneal abrasions compared with topical antibiotic ointment.
我们试图从愈合时间以及疼痛和不适程度的减轻方面，评估眼罩在治疗外伤性角膜擦伤中的疗效。
本单盲前瞻性对照试验纳入了163名在一家大型大学附属医院急诊科就诊的外伤性角膜擦伤患者。符合条件的患者被分配到以下两种治疗方案之一：患眼使用局部抗生素眼膏并覆盖封闭眼罩（n = 82）或每天4次局部使用抗生素眼膏但不使用封闭眼罩（n = 81）。每24小时对患者进行复查，直至角膜愈合。由急诊医生在不了解患者所属治疗组的情况下，使用带有荧光素染色的裂隙灯进行愈合评估。每次就诊时使用视觉模拟量表评估不适程度。
两个治疗组在角膜损伤大小、从受伤到首次急诊就诊的延迟时间、是否存在异物或铁锈症、初始不适程度以及特定症状（刺激感、异物感、畏光、眼红和疼痛）方面相似。在使用眼罩的组中，1天、2天和3天后愈合的累积发生率分别为51%、78%和92%，而未使用眼罩的组分别为60%、83%和88%。在使用眼罩的组中，初始不适症状在1天、2天和3天后分别减轻了4.8、4.1和5.5厘米，而未使用眼罩的组分别减轻了3.3、5.1和6.5厘米。
与局部使用抗生素眼膏相比，眼罩在治疗外伤性角膜擦伤中似乎并无益处。
