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准分子激光角膜切削术后第4天与第7天绷带式隐形眼镜取出的比较:一项随机临床试验

Comparison of bandage contact lens removal on the fourth versus seventh postoperative day after photorefractive keratectomy: A randomized clinical trial.

作者信息

Mohammadpour Mehrdad, Shakoor Delaram, Hashemi Hassan, Aghaie Meybodi Mohamad, Rajabi Fateme, Hosseini Pegah

机构信息

Ophthalmology Department, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

Eye Research Center, Farabi Eye Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Curr Ophthalmol. 2016 Sep 23;29(2):103-107. doi: 10.1016/j.joco.2016.08.008. eCollection 2017 Jun.

Abstract

PURPOSE

To compare the outcomes of bandage contact lens (BCL) removal on the fourth versus seventh post-operative day following photorefractive keratectomy (PRK).

METHODS

This study recruited eyes of patients who underwent PRK surgery. The patients were randomly assigned to 2 groups. In Group 1 BCL was removed on the 4th postoperative day, while in Group 2, BCL was removed on the 7th postoperative day. After BCL removal, patients were asked to express their pain score and eye discomfort. At one and three months follow-up examinations, visual acuity scale was assessed. Slit-lamp examination was performed in all visits to evaluate complications.

RESULTS

260 eyes of 130 patients underwent PRK. The age and sex ratio were not significantly different between the two groups. One month after the surgery, the logMAR uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) were significantly lower in Group 2 (P value = 0.016, 0.001 respectively), however, the UDVA and CDVA were not significantly different after 3 months (P > 0.05). In Group 1, filamentary keratitis (FK) was observed in 10 (7.6%) eyes, 6 (4.61%) eyes were diagnosed with recurrent corneal erosion (RCE) and corneal haze was detected in 3 (2.3%) eyes. However, in Group 2, RCE was observed in 4 (2.3%) and FK was noted in 4 (3.07%) eyes. No haze was seen in Group 2. The difference in rate of complications was statistically significant (14.6% and 6.1% in Groups 1 and 2, respectively, P = 0.02). Pain and eye discomfort scores were not significantly different (P > 0.05). There was no major complications including infectious keratitis in either groups.

CONCLUSION

Following PRK surgery, BCL removal on the seventh postoperative day yields faster visual rehabilitation and lower rate of postoperative complications with no increase in eye pain, discomfort or infection.

摘要

目的

比较准分子激光角膜切削术(PRK)术后第四天与第七天拆除绷带式隐形眼镜(BCL)的效果。

方法

本研究纳入接受PRK手术患者的眼睛。患者被随机分为两组。第一组在术后第4天拆除BCL,而第二组在术后第7天拆除BCL。拆除BCL后,要求患者表达疼痛评分和眼部不适情况。在术后1个月和3个月的随访检查中,评估视力表。每次就诊时均进行裂隙灯检查以评估并发症。

结果

130例患者的260只眼睛接受了PRK手术。两组之间的年龄和性别比例无显著差异。术后1个月,第二组的logMAR未矫正远视力(UDVA)和矫正远视力(CDVA)显著较低(P值分别为0.016、0.001),然而,3个月后UDVA和CDVA无显著差异(P>0.05)。第一组中,10只(7.6%)眼睛观察到丝状角膜炎(FK),6只(4.61%)眼睛被诊断为复发性角膜糜烂(RCE),3只(2.3%)眼睛检测到角膜 haze。然而,在第二组中,4只(2.3%)眼睛观察到RCE,4只(3.07%)眼睛注意到FK。第二组未见到haze。并发症发生率的差异具有统计学意义(第一组和第二组分别为14.6%和6.1%,P = 0.02)。疼痛和眼部不适评分无显著差异(P>0.05)。两组均未出现包括感染性角膜炎在内的重大并发症。

结论

PRK手术后,术后第七天拆除BCL可实现更快的视力恢复,且术后并发症发生率较低,同时不会增加眼部疼痛、不适或感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5e4d/5463006/61c0f272bf9d/gr1.jpg

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