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交联手术后两种硅水凝胶绷带镜的疗效。

Efficacy of two silicone-hydrogel bandage contact lenses after corneal crosslinking.

机构信息

Department of Ophthalmology, Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine, Hatay, Turkey.

出版信息

Clin Exp Optom. 2021 May;104(4):505-509. doi: 10.1080/08164622.2021.1878838. Epub 2021 Feb 10.

DOI:10.1080/08164622.2021.1878838
PMID:33689606
Abstract

Silicone-hydrogel (SiH) contact lenses are frequently used as a bandage after anterior segment surgical procedures. Several types of lenses may exhibit clinical performances with different characteristics. This study aims to evaluate the efficacy of two SiH contact lenses following corneal crosslinking (CXL). Forty-nine keratoconus patients scheduled for consecutive CXL surgery in both eyes were included in this comparative, double-blind, prospective study. A Balafilcon A (Pure Vision 2 HD, Bausch+Lomb, Rochester, NY, USA) or Lotrafilcon B (Air Optix Aqua, Ciba Vision, Duluth, GA, USA) lens was fitted in a randomised fashion in the eyes at the end of the CXL. Remaining epithelial defect area measured by slitlamp biomicroscopy, subjective level of pain and discomfort with visual analogue scale (VAS) and total number of oral analgesics taken were evaluated and compared at post-operative days 0, 1, 2 and 3. The average epithelial defect size was significantly smaller in the eyes with Lotrafilcon B than the eyes with Balafilcon A at post-operative Day 1 (31.2 ± 4.3 mm and 33.8 ± 5.2 mm, respectively, p < 0.001) and Day 2 (8.2 ± 3.6 mm and 10.5 ± 5.4 mm, respectively, p = 0.039). There was no statistically significant in the average epithelial defect size between the groups at Day 3 (p = 0.859). Re-epithelialisation time was similar in both groups (p = 0.317) There was no statistically significant difference in VAS scores regarding the lens type in any post-operative follow-up. The mean oral analgesic numbers were similar in both groups (p = 0.217). SiH contact lenses can be used as an effective bandage for corneal re-epithelialisation after CXL. The material and features of bandage contact lens used after CXL may affect the corneal re-epithelialisation process. Lotrafilcon B lens showed faster re-epithelialisation at post-operative days 1 and 2 after CXL.

摘要

硅水凝胶(SiH)隐形眼镜常被用作眼前节手术后的绷带。有几种类型的镜片可能具有不同特点的临床性能。本研究旨在评估两种硅水凝胶隐形眼镜在角膜交联(CXL)后的疗效。49 例圆锥角膜患者双眼连续接受 CXL 手术,纳入本研究。采用随机、双盲、前瞻性研究。在 CXL 结束时,随机在一只眼上佩戴 Balafilcon A(Pure Vision 2 HD,Bausch+Lomb,Rochester,NY,USA)或 Lotrafilcon B(Air Optix Aqua,Ciba Vision, Duluth,GA,USA)隐形眼镜。术后第 0、1、2 和 3 天,用裂隙灯生物显微镜测量剩余上皮缺损面积,用视觉模拟评分(VAS)评估主观疼痛和不适程度,并比较总口服镇痛药的使用次数。术后第 1 天(分别为 31.2 ± 4.3mm 和 33.8 ± 5.2mm,p < 0.001)和第 2 天(分别为 8.2 ± 3.6mm 和 10.5 ± 5.4mm,p = 0.039),Lotrafilcon B 组的平均上皮缺损面积明显小于 Balafilcon A 组。第 3 天两组平均上皮缺损面积无统计学差异(p = 0.859)。两组的上皮再上皮化时间相似(p = 0.317)。在任何术后随访中,两组的 VAS 评分均无统计学差异(p = 0.217)。两组的平均口服镇痛药用量相似(p = 0.217)。硅水凝胶隐形眼镜可作为 CXL 后角膜再上皮化的有效绷带。CXL 后使用的绷带隐形眼镜的材料和特性可能会影响角膜再上皮化过程。Lotrafilcon B 镜片在 CXL 后第 1 和第 2 天的上皮再上皮化更快。

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