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评估去除无复杂角膜异物后密切随访的必要性。

Evaluating the need for close follow-up after removal of a noncomplicated corneal foreign body.

机构信息

Department of Ophthalmology, Hotel Dieu Hospital, Queen's University, Kingston, Ontario, Canada.

出版信息

Cornea. 2014 Nov;33(11):1193-6. doi: 10.1097/ICO.0000000000000210.

Abstract

PURPOSE

The purpose of this study was to evaluate the need for close follow-up after removal of noncomplicated corneal foreign bodies.

METHODS

This is an observational prospective cohort study of 60 eyes in noncontact lens wearers with corneal foreign bodies outside the visual axis. Foreign bodies were removed and patients were followed as per the Wills Eye Manual guideline for 1 to 3 days after foreign body extraction, and every 3 to 5 days until resolution of the epithelial defect. Patients were asked to record their symptoms of eye pain, eye irritation, eye redness, and visual acuity on a visual analog scale to monitor symptoms related to development of infectious keratitis. The primary endpoint was resolution of the epithelial defect.

RESULTS

The average time to resolution of the epithelial defect was 4.34 ± 1.56 days, with an average of 2.2 ± 1.23 follow-up visits after removal. One patient developed infectious keratitis (1.67%). Symptoms showed a statistically significant improvement in patients who had healed epithelial defects, and a statistically significant worsening in the 1 patient who developed infectious keratitis (sensitivity = 1 and specificity = 0.915).

CONCLUSIONS

Few noncomplicated injuries develop infectious keratitis. We recommend fewer follow-ups for these injuries. However, if patients develop any worsening in eye pain, irritation, redness, or decrease in their visual acuity, they should return promptly for reassessment.

摘要

目的

本研究旨在评估非复杂性角膜异物取出后密切随访的必要性。

方法

这是一项对 60 例非接触镜佩戴者的非视轴性角膜异物的观察性前瞻性队列研究。异物取出后,患者按照 Wills Eye 手册指南随访 1 至 3 天,然后每 3 至 5 天随访一次,直至上皮缺损愈合。患者需记录眼痛、眼刺激、眼红和视力等症状的视觉模拟评分,以监测与感染性角膜炎发展相关的症状。主要终点为上皮缺损愈合。

结果

上皮缺损平均愈合时间为 4.34±1.56 天,平均去除后随访 2.2±1.23 次。1 例患者发生感染性角膜炎(1.67%)。有愈合上皮缺损的患者症状明显改善,而发生感染性角膜炎的 1 例患者症状明显恶化(敏感性为 1,特异性为 0.915)。

结论

少数非复杂性损伤会发展为感染性角膜炎。我们建议对这些损伤进行较少的随访。但是,如果患者的眼痛、刺激、眼红或视力下降任何方面出现恶化,应立即返回重新评估。

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