Hu Zizhong, Ding Yuzhi, Zheng Xinhua, Yuan Songtao, Li Jia, Xie Ping, Liu Qinghuai
Department of Ophthalmology (Z.H., Y.D., X.Z., S.Y., J.L., P.X., and Q.L.), The First Affiliated Hospital of Nanjing Medical University, Nanjing, China; Department of Ophthalmology (Y.D.), Zhongda Hospital Southeast University, Nanjing, China; and Department of Ophthalmology (X.Z.), Wuxi Children's Hospital, Wuxi, China.
Eye Contact Lens. 2018 Nov;44 Suppl 2:S355-S360. doi: 10.1097/ICL.0000000000000491.
To design a rigid contact lens (CL) to be used in combination with a wide-angle viewing system and analyze its protection for corneal epithelial during vitreous-retinal surgery.
A thin and lightweight rigid CL was designed and constructed. The impact of the CL on the visualized fundus range was evaluated using a concrete eye model. Patients with severe proliferative diabetic retinopathy (PDR) were randomized to either the CL group, corneal protective agent (CPA) group, or balanced salt solution (BSS) group. All patients underwent phacoemulsification and a standard 23-gauge three-port vitrectomy. Surgery time and corneal fluorescein staining score (FSS) postoperatively were mainly measured.
In the eye model, a larger area of fundus was visualized with the use of our CL under 128 D or 60 D Resight lens. The mean surgery time was 51.36±8.06 min, 50.89±8.26 min, and 55.46±9.14 in CL, CPA, and BSS group, respectively (F=2.325, P=0.105). In eight eyes in the BSS group, corneal epithelial layer was peeled off because the dryness of the cornea could not maintain a clear fundus image. The FSS in BSS group was markedly higher than that of CL and BSS group 1 day (P<0.001), 3 days (P<0.001), and 7 days (P=0.002) postoperatively. There was no statistical significance of the FSS between CL and CPA group at each follow-up endpoint.
The CL that we designed can slightly enlarge the visible fundus range and efficiently protect corneal epithelium during vitrectomy for patients with PDR.
设计一种与广角观察系统联合使用的硬性接触镜（CL），并分析其在玻璃体视网膜手术中对角膜上皮的保护作用。
设计并制作了一种薄且轻质的硬性CL。使用实体眼模型评估CL对可视化眼底范围的影响。将重度增殖性糖尿病视网膜病变（PDR）患者随机分为CL组、角膜保护剂（CPA）组或平衡盐溶液（BSS）组。所有患者均接受了超声乳化白内障吸除术和标准的23G三通道玻璃体切除术。主要测量手术时间和术后角膜荧光素染色评分（FSS）。
在眼模型中，在128D或60D Resight透镜下使用我们的CL可观察到更大面积的眼底。CL组、CPA组和BSS组的平均手术时间分别为51.36±8.06分钟、50.89±8.26分钟和55.46±9.14分钟（F=2.325，P=0.105）。BSS组中有8只眼的角膜上皮层剥脱，因为角膜干燥无法维持清晰的眼底图像。BSS组术后1天（P<0.001）、3天（P<0.001）和7天（P=0.002）的FSS明显高于CL组和CPA组。在每个随访终点，CL组和CPA组之间的FSS无统计学意义。
我们设计的CL可略微扩大可见眼底范围，并在PDR患者玻璃体切除术中有效保护角膜上皮。
