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眼部润滑与绷带式隐形眼镜治疗复发性角膜糜烂综合征的随机对照研究

Randomized Controlled Study of Ocular Lubrication Versus Bandage Contact Lens in the Primary Treatment of Recurrent Corneal Erosion Syndrome.

作者信息

Ahad Muhammad A, Anandan Maghizh, Tah Vikas, Dhingra Sumit, Leyland Martin

机构信息

*Oxford Eye Hospital, Oxford, United Kingdom; and †Department of Ophthalmology, Royal Berkshire Hospital, Reading, United Kingdom.

出版信息

Cornea. 2013 Oct;32(10):1311-4. doi: 10.1097/ICO.0b013e31829dec39.

Abstract

PURPOSE

To investigate the efficacy of bandage contact lenses (BCLs) in comparison with that of ocular lubricants (OLs) in the initial management of recurrent corneal erosion syndrome.

METHODS

A randomized controlled trial of 29 patients with recurrent corneal erosion syndrome presenting to the ophthalmology departments of the Oxford Eye Hospital and the Royal Berkshire Hospital, United Kingdom. The patients were randomized to wear either BCLs (for a 3-month duration, replaced every 30 days) or use OLs (4 times a day, with Lacri-Lube ointment at night for 3 months). The patients were assessed monthly for 4 months, and their symptoms were graded by visual analog scores. The main outcome measure was the complete resolution of symptoms with no noticeable corneal surface abnormality. Patients with a complete resolution were followed up for another 3 months to check for recurrence.

RESULTS

Fourteen patients were randomized to the BCL arm, and 15 were randomized to the OL arm. After 3 months, a complete resolution was achieved in 71% of the patients (10/14) with BCLs compared with that achieved in 73% of the patients (11/15) on OLs (P > 0.05). Partial resolution was noted in 7% of the patients with BCLs versus 13% of the patients on OLs. Twenty-one percent of the patients in the BCL group and 13% of the patients in the OL group failed to respond to the treatment. Patients on BCLs had earlier resolution of symptoms, with a mean time of 5 weeks compared with 9 weeks for OLs (P = 0.02). None of the patients with BCLs developed adverse side effects.

CONCLUSIONS

BCLs do not increase the likelihood of complete resolution when compared with OLs in the initial management of RCES. However, BCL treatment seems safe, and some patients experience earlier relief from symptoms.

摘要

目的

比较绷带式隐形眼镜(BCL)与眼部润滑剂(OL)在复发性角膜糜烂综合征初始治疗中的疗效。

方法

在英国牛津眼科医院和皇家伯克郡医院眼科进行的一项随机对照试验,纳入29例复发性角膜糜烂综合征患者。患者被随机分为佩戴BCL组(持续3个月,每30天更换一次)或使用OL组(每天4次,夜间使用Lacri-Lube眼膏,持续3个月)。患者在4个月内每月接受评估,症状通过视觉模拟评分进行分级。主要结局指标是症状完全缓解且角膜表面无明显异常。症状完全缓解的患者再随访3个月以检查是否复发。

结果

14例患者被随机分配到BCL组,15例被随机分配到OL组。3个月后,佩戴BCL的患者中有71%(10/14)症状完全缓解,而使用OL的患者中有73%(11/15)症状完全缓解(P>0.05)。佩戴BCL的患者中有7%部分缓解,而使用OL的患者中有13%部分缓解。BCL组有21%的患者、OL组有13%的患者对治疗无反应。佩戴BCL的患者症状缓解更早,平均时间为5周,而使用OL的患者为9周(P=0.02)。佩戴BCL的患者均未出现不良反应。

结论

在复发性角膜糜烂综合征的初始治疗中,与OL相比,BCL并未增加症状完全缓解的可能性。然而,BCL治疗似乎是安全的,一些患者症状缓解更早。

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