Li Jing, Ma Yu, Huang Xiaohan, Xu Lanfang, Tang Shaohua
Department of Ophthalmology, Beijing Jishuitan Hospital, Beijing, People's Republic of China.
Ther Clin Risk Manag. 2020 Nov 13;16:1109-1115. doi: 10.2147/TCRM.S277282. eCollection 2020.
The clinical efficacy of eye drops in the treatment of recurrent corneal erosion syndrome (RCES) is not satisfactory. Many studies have confirmed the positive effect of the bandage contact lens (BCL) in corneal diseases, but not many in patients with RCES. The purpose of this study is to investigate the efficacy of the BCL compared with deproteinized calf blood extract eye gel in the initial treatment of RCES.
Forty-seven patients with RCES treated in our hospital from September 2010 to September 2018 were retrospectively analyzed, including 24 cases (26 eyes) in the bandage contact lenses (BCLs) group wearing bandage contact lens and 23 cases (24 eyes) in the drug group treated with deproteinized calf blood extract eye gel. The efficacy was evaluated after 3 months of treatment, with a mean follow-up time of 21.15 ± 1.71 months in the BCL group and 20.87 ± 1.89 months in the drug group. Corneal erosion resolution, pain relief, visual acuity recovery time, recurrence and complications were observed.
After 3 months of treatment, 22 eyes (22/26, 84.6%) in the BCLs group achieved complete resolution, compared with 14 eyes (14/24, 58.3%) in the drug group (P <0.05). The corneal healing time in the BCLs group was 4.77 ± 4.51 weeks, which was significantly shorter than that in the drug group (9.83 ± 5.93 weeks (P <0.01)). At 1 and 2 months after treatment, the visual analogue score (VAS) in the BCLs group (3.28 ± 1.15 at 1 month and 1.90 ± 0.77 at 2 months) decreased more significantly than that in the drug group (4.54 ± 0.89 at 1 month and 2.43 ± 0.93 at 2months, P =0.000 at 1 month and P=0.034 at 2 months). At 3 months after treatment, the mean BCVA in the BCL group (logMAR 0.03±0.08) improved more significantly than that in the drug group (logMAR 0.14±0.12,P=0.001). The complete recovery time of visual acuity was 5.46 ± 4.43 weeks in the BCLs group, compared with 10.33 ± 6.12 weeks in the drug group (P =0.003). During further follow-up, recurrence was observed in 2 eyes (2/22, 9.1%) of the BCLs group and 6 eyes (6/14, 42.8%) of the drug group. No patient in both groups developed adverse side effects.
Bandage contact lenses are safe and effective in the initial treatment of RCES. Compared with topical deproteinized calf blood extract eye gel, the use of BCLs can provide a higher cure rate, better pain control, faster visual recovery and lower recurrence rate.
Chinese Clinical Trial Registry, ChiCTR2000031241. Registered 25 March 2020- Retrospectively registered, http://www.chictr.org.cn/edit.aspx?pid=51309andhtm=4.
滴眼液治疗复发性角膜糜烂综合征(RCES)的临床疗效并不理想。许多研究已证实绷带式隐形眼镜(BCL)在角膜疾病治疗中的积极作用,但针对RCES患者的研究并不多。本研究旨在探讨BCL与脱蛋白小牛血提取物眼用凝胶相比,在RCES初始治疗中的疗效。
回顾性分析2010年9月至2018年9月在我院治疗的47例RCES患者,其中绷带式隐形眼镜(BCL)组24例(26眼)佩戴绷带式隐形眼镜,药物组23例(24眼)使用脱蛋白小牛血提取物眼用凝胶治疗。治疗3个月后评估疗效,BCL组平均随访时间为21.15±1.71个月,药物组为20.87±1.89个月。观察角膜糜烂愈合情况、疼痛缓解情况、视力恢复时间、复发情况及并发症。
治疗3个月后,BCL组22眼(22/26,84.6%)完全愈合,药物组为14眼(14/24,58.3%)(P<0.05)。BCL组角膜愈合时间为4.77±4.51周,显著短于药物组(9.83±5.93周,P<0.01)。治疗1个月和2个月时,BCL组的视觉模拟评分(VAS)(1个月时为3.28±1.15,2个月时为1.90±0.77)下降幅度比药物组更显著(1个月时为4.54±0.89,2个月时为2.43±0.93,1个月时P=0.000,2个月时P=0.034)。治疗3个月时,BCL组的平均最佳矫正视力(BCVA)(logMAR 0.03±0.08)改善幅度比药物组更显著(logMAR 0.14±0.12,P=0.001)。BCL组视力完全恢复时间为5.46±4.43周,药物组为10.33±6.12周(P=0.003)。在进一步随访中,BCL组有2眼(2/22,9.1%)复发,药物组有6眼(6/14,42.8%)复发。两组均无患者出现不良反应。
绷带式隐形眼镜在RCES的初始治疗中安全有效。与局部使用脱蛋白小牛血提取物眼用凝胶相比,使用BCL可提供更高的治愈率、更好的疼痛控制、更快的视力恢复及更低的复发率。
中国临床试验注册中心,ChiCTR2000031241。2020年3月25日注册——回顾性注册,http://www.chictr.org.cn/edit.aspx?pid=51309andhtm=4。