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接触镜诱导的 Lisch 上皮角膜营养不良的退行性变化。

Contact lens-induced regression of Lisch epithelial corneal dystrophy.

机构信息

Department of Ophthalmology, Klinikum Hanau, Hanau, Germany.

出版信息

Cornea. 2010 Mar;29(3):342-5. doi: 10.1097/ICO.0b013e3181aabefe.

Abstract

PURPOSE

To describe the use of soft contact lenses (CL) to reduce the epithelial opacities of Lisch epithelial corneal dystrophy (LECD). First presentation of confocal microscopy in LECD.

METHODS

Two unrelated female patients with LECD demonstrated a central gray opacity with distinct visual impairment. The first patient wore a daily hydroxyethlmethacrylate (HEMA) CL for 3 months and the second, a daily silicone hydrogel CL for 1 month. Pre-CL and post-CL appearances of the cornea were photodocumented at the slit lamp. Additionally, in the second patient, a confocal microscopic evaluation of LECD was performed.

RESULTS

In both patients, the wearing of CL resulted in a distinct reduction of central corneal opacification with a visual improvement. Discontinued wearing of CL induced again a progression of opacity. The confocal microscopy disclosed the typical intracytoplasmatic vacuolization of the involved epithelial cells.

CONCLUSIONS

Wearing CL for a longer duration causes a significant regression of corneal opacities in LECD. The etiology of this phenomenon is interpreted as a CL-induced thinning of corneal epithelium and reduction of epithelial layers.

摘要

目的

描述软性隐形眼镜(CL)在减少李希氏角膜上皮营养不良(LECD)上皮混浊中的应用。LECD 中首次出现共焦显微镜检查。

方法

两名无关的女性 LECD 患者表现为中央灰色混浊,伴有明显的视力损害。第一例患者佩戴每日羟乙基甲基丙烯酸酯(HEMA)CL 3 个月,第二例患者佩戴每日硅酮水凝胶 CL 1 个月。在裂隙灯下对 CL 前后角膜的外观进行了拍照记录。此外,对第二位患者进行了 LECD 的共焦显微镜评估。

结果

在这两位患者中,佩戴 CL 后中央角膜混浊明显减轻,视力改善。停止佩戴 CL 后,混浊再次进展。共焦显微镜显示受累上皮细胞的典型胞浆内空泡化。

结论

较长时间佩戴 CL 可导致 LECD 角膜混浊明显消退。这种现象的病因解释为 CL 诱导的角膜上皮变薄和上皮层减少。

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