背景:经上皮角膜交联(CXL)是一种治疗圆锥角膜的新型手术方法,这是一种双侧不对称眼科疾病,伴有进行性角膜扩张。硅水凝胶(SiH)隐形眼镜已广泛用于临床眼科,作为术后眼科干预。然而,经上皮CXL后理想的晶状体应用时间仍不确定.这里,我们的目的是研究经上皮CXL治疗圆锥角膜后立即使用角膜接触镜的效果和舒适度。
方法:在这项前瞻性研究中,从2021年9月至2023年1月纳入60例接受跨上皮CXL治疗的圆锥角膜患者,男女比例为39:21,平均年龄为25.42±5.47岁。将患者随机分为两组:A组30例患者术后7天佩戴硅水凝胶隐形眼镜,B组30例患者佩戴相同的隐形眼镜3天。对患者的10项主观眼科症状进行了调查,包括疼痛,畏光,异物感,撕裂,燃烧,视力模糊,干眼,难以睁开眼睛,收敛性,和刺痛。眼科征象,包括角膜水肿和结膜充血,由一名临床医生在术后第1、3和7天记录。
结果:每次手术都很容易进行,没有并发症,两组术后第7天(P=0.04),其中B组得分(0.01±0.41)低于A组(0.12±0.29),而两组的角膜水肿在术后第5天和第7天显着不同(A组分别显示了0.17±0.14和0.08±0.11的结果,而B组在相应时间分别为0.10±0.13和0.03±0.07)。
结论:经上皮CXL术后立即使用硅水凝胶角膜晶状体可有效缓解术后眼窘迫,特别是三天的使用期限作为理想的持续时间。
BACKGROUND: Transepithelial corneal crosslinking (CXL) is a novel surgical approach for the treatment of keratoconus, which is a bilateral asymmetrical ophthalmological disease accompanied by progressive corneal ectasia. Silicon hydrogel (SiH) contact lenses have been extensively used in clinical ophthalmologic medicine, as a postoperative ophthalmological intervention. However, the ideal lens application duration after transepithelial CXL remains uncertain. Here, we aimed to investigate the effects and comfort of immediate corneal contact lens use after transepithelial CXL for keratoconus.
METHODS: In this prospective study, 60 patients with keratoconus who underwent transepithelial CXL treatment were enrolled from September 2021 to January 2023 with a male:female ratio of 39:21, and an average age of 25.42 ± 5.47 years. The patients were divided randomly into two groups: group A contained 30 patients wearing silicone hydrogel contact lenses for 7 days postoperatively, and group B contained 30 patients wearing the same contact lenses for 3 days. Ten subjective ophthalmologic symptoms were surveyed by the patients, including pain, photophobia, foreign body sensation, tearing, burning, blurred vision, dry eyes, difficulty opening the eyes, astringency, and stinging. Ophthalmologic signs, including corneal edema and conjunctival congestion, were recorded by a single clinician on postoperative days 1, 3, and 7.
RESULTS: Each surgical procedure was readily performed without complications, and both groups postoperative day 7 (P = 0.04), where group B scored (0.01 ± 0.41) lesser than group A (0.12 ± 0.29), whilst corneal edema in both groups recorded significantly different on postoperative days 5 and 7 (group A demonstrated the result of 0.17 ± 0.14 and 0.08 ± 0.11 for the respective days, whereas group B indicated 0.10 ± 0.13 and 0.03 ± 0.07 at the corresponding times).
CONCLUSIONS: Immediate use of silicone hydrogel corneal lenses after transepithelial CXL effectively alleviates postoperative ocular distress, particularly with a three-day use period as the ideal duration.