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Keratoconus is a progressive blinding eye disease that characterized by corneal thinning and protrusion, which accompanied with irregular astigmatism and impaired visual acuity.The irregular astigmatism of early keratoconus can be corrected by spectacles. For the irregular astigmatism of moderate to severe keratoconus, spectacles are no longer suitable, and contact lenses are the best choice for patients to restore vision. There are various types of contact lenses, making the selection very difficult. In addition, trying on lenses for a long time will increase the discomfort and overall feeling of patients, and greatly increase the workload of doctors. Thus, the article aims to summarize and discuss the classification of contact lenses, the application of contact lenses in different types of keratoconus, the complications of contact lens, and the current status and prospect of contact lenses, with a view to understanding the management and clinical application of contact lenses in keratoconus patients and to further improving the application value of contact lenses in keratoconus.
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@#AIM: To evaluate the efficacy evaluation of the combined application of bandage contact lens after pterygium excision surgery by Meta-analysis.<p>METHODS: Randomized controlled clinical studies on combined application of corneal bandage contact lens after pterygium excision were retrieved from PubMed, Cochrane Library, Wanfang, VIP, CNKI and other databases from May 2014 to May 2020. Data were extracted and Meta-analysis was performed.<p>RESULTS:Totally 11 randomized controlled clinical studies were included, including 10 in Chinese and 1 in English, with 864 patients. Meta-analysis results showed that 1d postoperative \〖<i>MD</i>= -1.57, 95%<i>CI</i>=(-1.72, -1.41), <i>P</i><0.00001\〗, 2d postoperative \〖<i>MD</i>= -1.35, 95%<i>CI</i>=(-1.59, -1.11), <i>P</i><0.00001\〗, 7d postoperative \〖<i>MD</i>= -0.64, 95%<i>CI</i>=(-0.78, -0.50), <i>P</i><0.00001\〗 combined application of corneal bandage contact lens can better reduce the degree of ocular pain in patients; And 1d postoperative \〖<i>MD</i>= -1.23, 95%<i>CI</i>=(-1.51, -0.95), <i>P</i><0.00001\〗, 7d postoperative\〖<i>MD</i>= -0.44, 95%<i>CI</i>=(-0.50, -0.39), <i>P</i><0.00001\〗 combined application of corneal bandage contact lens can better promote the condition of corneal epithelium. <p>CONCLUSION:The bandage contact lens could markedly release pain response after pterygium excision surgery, promote corneal epithelium recovery, which is beneficial to reduce the symptoms of clinical discomfort.
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@#AIM: To investigate the clinical effects of soft corneal contact lens after excision of pterygium and limbal stem cell transplantation in elderly patients. <p>METHODS:Totally 90 patients(90 eyes)with unilateral pterygium were divided into two groups according to the random number table method. The observation group(45 cases)were treated with soft corneal contact lens after corneal limbal autograft transplantation merely, 45 cases of the control group were treated by autologous limbal stem cell transplantation. According to the data obtained from two groups of patients, the following indicators were compared: corneal healing time, symptom score of corneal irritation in 1d, 3d, 5d, 7d after operation, postoperative 24h、48h, two groups of patients with pain(VAS score),the recurrence rate of pterygium. <p>RESULTS: In control group, the corneal healing time(5.38±1.67d)was more than that of observation group(3.10±1.12d; <i>P</i><0.05); Score of the corneal stimulation symptom and VAS after operation were higher than those of the control group(<i>P</i><0.05), and the difference in recurrence of pterygium was not statistically significant(<i>P</i>>0.05).<p>CONCLUSION: Autologous corneal stem cells combined with soft corneal contact lens in treatment of elderly patients with pterygium can reduce the healing time, and reduce the postoperative symptom of corneal irritation, meanwhile it has no effect on the recurrence rate of pterygium.
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The corneal contact bandage lens has gained clinicians acceptance for their wearing comfort and definite curative effects in ocular surface protection and damage reparation.Recently,application fields of contact bandage lens are still expanding with continuous exploration and development of new materials and function.To noninfectious ocular surface diseases,bandage lens obviously alleviate irritate symptoms and accelerate tissue healing.The application of bandage lens in infectious ocular surface diseases remains controversial.The bandage lens has become a routine intervention of ocular trauma and corneal perforation.It can also improve ocular surface microenvironment after the surgery of glaucoma,cataract,pterygium,corneal transplantation and refraction.It is an adjuvant therapy for aniridia,dry eye and children ocular surface diseases.This review summarized the history,current corneal contact bandage lens in preventing and treating ocular surface diseases.
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@#AIM:To evaluate the effect of soft contact lens on the comfort of postoperative patients with recurrent pterygium. <p>METHODS: For 100 eyes of 98 patients after recurrent pterygium excision, the conjunctival implant with limbal stem cells from the upper part of the cornea was used, and the scleral surface of the operation area was transferred and covered. Fifty eyes were treated with corneal bandage lens for 5d(Group A)and 50 eyes were conventionally ensheathed(Group B). The time of corneal wound healing and various symptoms and signs were observed after operation. <p>RESULTS: Compared with Group B, 1d after pterygium, the symptoms and signs of corneal irritation in Group A were significantly less(<i>P</i><0.05), and the corneal epithelial healing was significantly faster and better(<i>P</i><0.05). <p>CONCLUSION: The corneal contact lens can obviously improve the early postoperative corneal irritation in patients with pterygium, promote corneal wound healing and relieve postoperative discomfort.
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·AIM: To evaluate the clinical effect of fresh amniotic membrane transplantation in combination with bandage type corneal contact lens in the treatment of pterygium. ·METHODS:This study was a prospective analysis of 600 pterygium excision patients (600 cases, 600 eyes) in the He Eye Hospital from January 2016 to June 2016. The patients were randomly and evenly divided into two groups: observation group and control group, 300 cases in each group (300 eyes). Observation group wore the bandage type corneal contact lens after surgery and took it down at fifth day. The control group did not. The degree of pain after surgery were evaluated at 2h, 1, 3 and 5d after surgery. The clinical outcomes in these two groups were compared in a 12mo postoperative follow-up observation. · RESULTS: There were no significant differences between the observation and control group in the percentage of age and gender and size of the pterygium (P>0.05). After surgery, the degree of pain of treatment group significantly decreased compared to control group, the difference was statistically significant(P<0.01). There were no significant differences between the 2 groups comparing treatment outcomes as the recurrence rate(P>0.05). · CONCLUSION: Bandage contact lenses could significantly release pain response after pterygium excision. But it can not reduce the recurrence rate.
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Objective To investigate the clinical effects of the Viscoat viscoelastic combined with soft corneal contact lens for central corneal perforation.Methods Six cases were collected and treated with corneal local debridement of which diameter were less than 2.0 mm.Six cases received Viscoat viscoelastic injection into their anterior chamber.And then soft corneal contact lens were worn.The curative effect indicators such as patients' symptom,visual acuity,slit lamp examination,intraocular pressure,confocal microscope and corneal endothelial cell counts were recorded in the follow-up periods.Results All the cases were healed with the recovery time of 1 month to 2 months;After treatment,the best corrected visual acuity of patients were increased to 0.6-0.8 and average corneal endothelial cell count was (3415.5 ±279.5)mm-2.No obvious scar was left in the cornea and no serious complicatious occurred during treatment.Conclusion For traumatic corneal central perforation with diameter is 2.0 mm or less can be treated with Viscoat viscoelastic combined with soft corneal contact lens.This therapy is worthy of popularize since it's satisfied prognosis and less economic burden.
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·AIM: To investigate the early effects of 3g/L sodium hyaluronate eye drops combined with soft contact lenses on corneal epithelial healing and local comfort.·METHODS: Totally 90 patients ( 90 eyes ) with primary monocular pterygium were randomly divided into three groups after pterygium excision surgeries ( n = 30, for each) . Each group received pterygium excision combined with limbal stem cell autograft transplantation. The research group wore soft corneal contact lens for 7d after the surgery, and the next day all of them were given 3g/L sodium hyaluronate and levofloxacin eye drops four times a day, tobrmycin and dexamethasone ophthalmic ointment once every night. The Group B did not wear the corneal contact lens, they were given levofloxacin eye drops four times a day and tobrmycin and dexamethasone ophthalmic ointment once every night. About the Group C, the 3g/L sodium hyaluronate eye drops was added on the basis of conventional medication of Group B. The time of corneal epithelial healing after surgery and the ocular pain score in different times were observed and contrasted.· RESULTS: Mean pain score of Group A were significantly lower than Group B and C at 6h, the first day and the third day after operation(P<0. 001), but there was no significant difference between the three groups at the fifth day and the seventh day (P>0. 05). The first day after the surgery, there were no eyes of corneal epithelium completely healed, but the complete healing rate of Group A were significantly higher than the other two group at the second day and the third day. (P<0. 05).·CONCLUSION: Early use of 3g/L hyaluronate sodium eye drops combined with soft corneal contact lenses after pterygium excision surgeries will not only accelerate corneal epithelial wound healing, but also relieve local pain, improve ocular comfort significantly.
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Background Suture stitching is currently the standard treatment for corneal penetrating injuries.The shortcomings of suture stitching have led to the exploration of non-sutured surgical methods.Tissue adhesive is a promising non-suture replacement procedure.Objective This study was to observe the effect of fibrin glue on large irregular rabbit corneal penetrating injury.Methods Eighteen pure white healthy rabbits were randomly divided into suture group and adhesive group.A total length of 6-mm non-self-sealing corneal penetrating injury in nonpupillary-area of the right eye formed with a 15° corneal puncture knife was repaired with fibrin glue plus temporary suture and therapeutic corneal contact lens (9 eyes) or with 3 to 5 interrupted 10-0 nylon sutures (9 eyes) with the fellow eyes acted as the internal controls respectively.Operative time was compared between the two groups.Clinic observation was performed with slit lamp microscope.Animals were humanely sacrificed for histologic examination at week 1,3,and 8 to evaluate wound healing.Results The average operation time was (3.48±0.48) minutes in the adhesive group,which was significantly lower than that in the suture group ([7.77 ± 1.30] minutes) (t =9.28,P＜ 0.01).The postoperative slit lamp microscope observation indicated corneal wounds were quickly and regularly healed in the glued corneas compared with the stitched ones.The histologic examination revealed that glued corneas had regular healing,mild inflammation,and no corneal neovascularization,while sutured corneas showed irregular fibrin arrays,a large number of inflammatory cells and macrophages infiltration around the suture,heavy inflammatory response.Neovascularization was found at week 3 postoperatively.Conclusions Fibrin glue combined with temporary suture and therapeutic corneal contact lens is an effective treatment in sealing large irregular corneal wounds with considerable advantages over traditional sutures,ircluding simplified operative technique,short surgery time,less postoperative irritation,mild inflammation,more regular wound healing,short healing time,and no corneal neovascularization.
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@#AIM: To investigate the effect of soft corneal contact lens on the recovery of corneal epithelial defects and the comfort in patients with diabetic retinopathy after vitrectomy. <p>METHODS: Twenty patients(20 eyes)with diabetic retinopathy whose corneal epithelium defected after vitrectomy were randomly divided into 2 groups. The trial group(10 eyes)received the combination treatment of wearing soft corneal contact lenses and eyedrops to promote corneal epithelial repair, and the control group(10 eyes)only received eyedrops. The corneal epithelial healing time was observed postoperatively. And the scores of the comfort in patients between two groups were compared. <p>RESULTS: The average duration of corneal epithelial defects was 4.1±1.20d in the trial group, and 14.2±6.07d in the control group, which was statistically significant different between the two groups(<i>P</i><0.05). After treatment, the patients in the trial group felt more comfortable compared with the ones in the control group. There was no significant statistical difference about the scores of the comfort between the two groups at postoperative 3mo(<i>P</i>>0.05). <p>CONCLUSION: The soft corneal contact lens could effectively treat patients with corneal epithelial defects after vitrectomy, and improve their comfort.
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Objective: To discuss the clinical efficacy of bandage contact lens (BCL)in pterygium excision combined with conjunctival transplantation for the older adults,and to explain its advantages.Methods:The clinical materials of 70 older patients (70 eyes ) who underwent the pterygium excision combined with conjunctival transplantation were retrospectively analyzed.They were divided into two groups according to the postoperative treatment.In the observation group,35 cases (35 eyes)wore BCL after operation.In control group,35 cases (35 eyes)were covered with normal eye pad.The scores of blurred vision,photophobia,foreign body sensation, lacrimation,eye-soreness,corneal fluorescence stain (FSC)and epithelial defect areas were observed at 1,3,7 and 10 d afer operation.Results:The scores of blurred vision,photophobia,foreign body sensation,lacrimation,eye-soreness of the patients in observation group were significantly lower than those in control group at 1,3,and 7 d afer operation (P 0.05).No complications of infection and implant healing badness were observed in all patients.Conclusion:BCL can significantly reduce the irritations after pterygium excision combined with conjunctival transplantation for the older adults and promote the healing of the corneal epithelium.
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To evaluate the clinical effect of therapeutic soft corneal contact lens in combination with fresh amniotic membrane transplantation in the treatment of pterygium and its clinical value. ●METHODS: This study was a retrospective analysis of 200 pterygium excision patients (200 cases, 220 eyes) in hospital from January 2010-June 2011. The patients were divided into two groups. Group 1 (100 cases, 110 eyes) were patients treated with fresh amniotic membrane transplantation and therapeutic soft corneal contact lens while group 2 ( control group, 100 cases, 110 eyes) did not use corneal contact lens. The clinical outcomes in these two groups were compared in a 6 - 18mo postoperative follow-up observation. ●RESULTS: ln control group using corneal contact lens the epithelium repair time ranged from 2 - 7d with an average time of 3. 8d; in group 1 the epithelial repair time ranged from 1 - 5d with an average time of 2. 5d. The patients were followed up for 6 - 18mo, 9 recurrent eyes were found in control group, the recurrence rate was 8. 2%; 5 recurrent eyes were found in experimental group the recurreat rate was 4. 5%. There were significant differences in the 2 groups comparing treatment outcomes (P ●CONCLUSlON:The therapeutic effect of fresh amniotic membrane transplantation after pterygium excision is enhanced by the therapeutic application of corneal contact lens. The epithelial repair time is shortened, the recurrence rate is reduced after pterygium excision and stimulative symptoms including photophobia, tearing, foreign body sensation and ophthalmodynia caused by corneal epithelial defect can be relieved.
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Objective To investigate the change of wave-front aberrations after Ortho-K contact lens(CL)by day and overnight wear.Design Retrospective case series.Participant 180 eyes of 92 myopic patients wearing Ortho-K CL.Method Wave-front aberra- tions of 180 eyes of 92 myopic patients wearing Ortho-K CL were analyzed.Patients were divided into by day wear and overnight wear groups.Wave-front aberrations were measured with WFA 1000B subjective aberrometer before and 1 month after Ortho-K CL wear. Wave-front aberrations at initial,after one month of CL fitting and without CL were measured in same condition,and RMS values for overall wave-front aberrations and each order of the Zernike aberrations were analyzed with Matlab software.Main Outcome Measures RMS value of Zernike coefficient of each order.Result Compared with initial aberration in wear by day group,total RMS and each or- der aberrations(except 2nd order)with lens fitting significantly increased(P0.05).Compared with initial aberration in overnight wear group,overall wavefront aberrations and the RMS(except 2nd,3rd and 6th order Zernike aberrations)with lens fitting significantly increased(P0.05).Conclusion The high order aberrations with lens fitting and without lens fit- ting increased in each group.The aberration with lens fitting in wear by day group was higher than that in overnight wear group,while the aberration without lens fitting in overnight wear group was higher than that in wear by day group.(Ophthalmol CHN,2007,16: 351-354)
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Objective To investigate the complications associated with wearing soft corneal contact lens. Methods This study involved 120 patients (205 eyes) wearing soft corneal contact lens from January 2004 to February 2005. The examination included eyesight, slit lamp, corneal fluorescein staining, break-up time of tear film before final diagnosis. Results There were 30 eyes of simple conjunctival congestion, 42 eyes of macropapillary conjunctivitis, 86 eyes of xerophthalmia, 62 eyes of keratopathy and 21 eyes of ciliary congestion and forming of new vessels. Conclusions Many complications such as simple conjunctival congestion, macropapillary conjunctivitis, xerophthalmia et al will be caused by wearing soft corneal contact lens. This indicates that wearing soft corneal contact lens should be strictly controlled and patients should be followed-up regularly.