Zaki Victor
Lexington Eye Associates, Westford, MA.
Medicine (Baltimore). 2017 Feb;96(6):e6020. doi: 10.1097/MD.0000000000006020.
This is a retrospective study aimed to determine the efficacy of mini-scleral contact lens in protecting the cornea and improving vision in cases of facial palsy.
Patients with facial palsy get exposure keratitis because the cornea is dry. They feel pain, discomfort and excessive watering. If left untreated, it leads to permanent damage to the cornea and loss of good functional vision. Mini-scleral lens keep the cornea covered by saline solution all wearing hours.
Three patients (4 eyes) with acoustic neuroma, two unilateral and one bilateral, who underwent acoustic neuroma surgeries resulting in facial palsy, are presented.The gold implant and lateral tarsorrhaphy were not enough for corneal protection.Two patients (patients 1 and 2) suffered continuous pain and watering. They had to apply thick lubricant, Lacri-Lube ointment (Allergan, Inc., Dublin, Ireland), several times daily to the affected eye for 15 years. The vision of these patients in the affected eyes were counting fingers (CF) at one foot.Patient 3 with bilateral facial palsy had exposure keratitis in both eyes resulting in constant watering, pain and blurred vision.
The 4 eyes were fitted with mini-scleral lenses. The lenses were 15.8 mm rigid gas permeable filled with preservative free saline solution that continuously covers the cornea all wearing hours.
In patients 1 and 2 with unilateral facial palsy, vision improved through the mini-scleral lenses to 20/30 and all their symptoms disappeared.The keratitis in case 3 with bilateral facial palsy disappeared within one week of mini-scleral lens use.Follow up for 2 years showed that these patients maintained good vision with no side effects.
Mini-scleral lenses protected the cornea, gave comfort and improved the vision and the quality of life of these three patients with facial palsy and should be considered for all patients with facial palsy.
这是一项回顾性研究，旨在确定迷你巩膜接触镜在面瘫患者中保护角膜和改善视力的疗效。
面瘫患者因角膜干燥而患暴露性角膜炎。他们感到疼痛、不适和流泪过多。如果不治疗，会导致角膜永久性损伤和良好功能性视力丧失。迷你巩膜镜在佩戴期间使角膜始终被盐溶液覆盖。
介绍了3例（4只眼）听神经瘤患者，其中2例为单侧，1例为双侧，他们接受了听神经瘤手术，导致面瘫。金植入物和外侧睑裂缝合术对角膜保护不足。2例患者（患者1和患者2）持续疼痛和流泪。他们必须每天多次在患眼涂抹厚厚的润滑剂泪然眼膏（爱尔康公司，爱尔兰都柏林），持续了15年。这些患者患眼的视力为1英尺处数指（CF）。双侧面瘫的患者3双眼患有暴露性角膜炎，导致持续流泪、疼痛和视力模糊。
4只眼佩戴了迷你巩膜镜。镜片为15.8毫米的硬性透气性镜片，填充无防腐剂的盐溶液，在佩戴期间持续覆盖角膜。
在单侧面瘫的患者1和患者2中，通过迷你巩膜镜视力提高到20/30，所有症状消失。双侧面瘫的患者3在使用迷你巩膜镜一周内角膜炎消失。随访2年显示这些患者保持了良好视力，无副作用。
迷你巩膜镜保护了角膜，给予了舒适感，改善了这3例面瘫患者的视力和生活质量，所有面瘫患者都应考虑使用。
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