Mayer S, Wirbelauer C, Häberle H, Altmeyer M, Pham D T
Klinik für Augenheilkunde, Vivantes Klinikum Neukölln, Berlin.
Klin Monbl Augenheilkd. 2005 Jan;222(1):41-5. doi: 10.1055/s-2004-813826.
Although postoperative eye patching is a common practice its background is not well known. Therefore the necessity of eye patching after cataract surgery in topical anesthesia from the medical point of view and the patients' subjective opinion was studied.
In this prospective and randomized study 133 patients received after cataract surgery either no covering of the eye (group1), a transparent eye shield for four hours (group 2), an eye pad for four hours (group 3) or an eye pad until the next morning (group 4). Clinical findings were noted and local symptoms, such as pain, foreign body sensation, tearing and photophobia were documented on a visual analogue scale (0 - 10). Furthermore, a questionnaire concerning the subjective opinion was handed out to the patient.
The clinical findings revealed no significant differences between the groups. The mean values for local pain were 0.94 +/- 1.56, for the foreign body sensation 1.41 +/- 2.02, for tearing 0.99 +/- 1.8 and for photophobia 1.05 +/- 1.99. Comparing the groups there was significantly more pain and foreign body sensation reported by the patients in group 3, who received eye patching for 4 hours. 91 % of the unpatched patients had no discomfort, whereas 53 % of the patients wearing an eye pad until the next morning considered it as unnecessary.
After cataract surgery in topical anesthesia only mild symptoms were noted. There were no significant differences between the groups in the objective clinical findings and the subjective feeling. These results indicate that after cataract surgery eye patching could be unnecessary.
尽管术后眼部包扎是一种常见做法,但其背景尚不清楚。因此,从医学角度和患者主观意见方面研究了表面麻醉下白内障手术后眼部包扎的必要性。
在这项前瞻性随机研究中,133例患者在白内障手术后分别接受以下处理:不遮盖眼睛(第1组)、佩戴透明眼罩4小时(第2组)、使用眼垫4小时(第3组)或使用眼垫直至次日早晨(第4组)。记录临床发现,并使用视觉模拟量表(0 - 10)记录疼痛、异物感、流泪和畏光等局部症状。此外,还向患者发放了一份关于主观意见的问卷。
临床发现显示各组之间无显著差异。局部疼痛的平均值为0.94±1.56,异物感为1.41±2.02,流泪为0.99±1.8,畏光为1.05±1.99。比较各组,第3组接受眼部包扎4小时的患者报告的疼痛和异物感明显更多。91%未包扎的患者没有不适,而53%佩戴眼垫直至次日早晨的患者认为没有必要。
表面麻醉下白内障手术后仅观察到轻微症状。客观临床发现和主观感受在各组之间无显著差异。这些结果表明白内障手术后可能无需眼部包扎。