Comparison of efficacy of corneal bandage contact lens or amniotic membrane in the treatment of pterygium / 眼科新进展

ABSTRACT

Objective To evaluate the efficacy of corneal bandage contact lens or amniotic membrane in the treatment of pterygium.Methods A total of 114 patients (114 eyes) with primary pterygium treated in our hospital from April 2015 to December 2016 were randomly divided into amniotic membrane group (61 patients) and bandage contact lens group (53 patients).All patients underwent local anesthesia with pterygium excision combined with autologous free conjunctival flap transplantation by the same surgeon.In the amniotic membrane group,10 mm × 15 mm lyophilized biological amuiotic membrane was used,and its basal plane was applied to cover the keratoconjunctival wound of the patient,followed by fixation with a 10-0 nylon thread.In the bandage contact lens group,a piece of Bausch & Lomb pure vision chip was used to cover the patient's cornea.The best corrected visual acuity,surface asymmetry index (SAI),surface regularity index (SRI) and corneal astigmatism were recorded before and at 1 month and 3 months after operation.Wong-Baker face was used to score the pain intensity.Results Two weeks after operation,the fluorescein staining showed that positive staining presented in 7 eyes of the amniotic membrane group and in 1 eye of the bandage contact lens group,and the difference in the positive rate of both groups was statistically significant (P ＜ 0.05).There was no significant difference in the best corrected visual acuity between the two groups before and after the operation (all P ＞0.05).There was no significant difference in corneal astigmatism between the two groups before the surgery (P ＞ 0.05),but at 1 month and 3 months after operation,the bandage contact lens group was lower than the amniotic membrane group,and the differences were statistically significant (both P ＜ 0.05).The preoperative SRI and SAI of the amniotic membrane group were 1.52 ± 0.83 and 1.68 ± 0.62,respectively,as well as 1.61 ± 0.66 and 1.73 ± 0.59 in the bandage contact lens group,respectively,and there was no significant difference between the two groups (all P ＞ 0.05).At 1 month and 3 months after the treatment,the SRI (0.99 ±0.72,0.63 ±0.58) and SAI (0.61 ±0.53,0.54 ±0.28) in the bandage contact lens group were lower than those in the amniotic membrane group [(1.28 ± 0.67,0.85 ± 0.47) and (0.97 ± 0.47,0.82 ± 0.35)],and the differences were statistically significant (all P ＜ 0.05).On the day of the surgery and on the first day after surgery,the pain index of the bandage contact lens group was lower than that of the amuiotic membrane group,and the differences were statistically significant (all P ＜ 0.05).There was no significant difference in the pain index between the bandage contact lens group and the amniotic membrane group at 2 weeks postoperatively (P ＞ 0.05).Three months after operation,there was recurrence in one eye (1.64％) in the amniotic membrane group and two eyes (3.77％) in the bandage contact lens group,and the recurrence rate was not statistically different (P ＞ 0.05).Conclusion There are better improvment of corneal repair,lower corneal refraction and lower pain scores when the bandage contact lens is used in pterygium surgery when compared with amniotic membrane.