Clinical Observation Of Corneal Bandage Contact Lens In The Treatment Of Exposed Keratitis

Objective:Observe and evaluate the clinical efficacy of corneal bandage contact lens assisted conventional drugs in the treatment of exposed keratitis.Methods:Forty-six patients(46 eyes)who were diagnosed as "exposure keratitis" in our hospital from September 1,2017 to January 1,2019 were prospectively studied.For patients who were suitable for non-surgical treatment and included in the study,they were divided into control group and experimental group by simple random method.Among them,16 patients(16 eyes)in the control group were treated with conventional drugs alone,and 30 patients(30 eyes)in the experimental group were treated with Baudrill’s PureVision corneal bandage lens to assist conventional drug therapy.The healing of corneal lesions after treatment for 3d,7d,14 d,21d,30 d,the time of cure,the wearing time of corneal bandage contact lens,and the infection caused by corneal bandage contact lens andwere observed.Results:Forty-six patients(46 eyes)were diagnosed with "exposure keratitis" in this study,including 20 males(20/46,43.5%)and 26 females(26/46,56.5%).The mean age of 46 patients was 51.8 ± 11.2 years.The first 10 cases(10/46,21.7%)in the ophthalmology department,the remaining 36 cases(36/46,78.3%)were treated in the ICU,neurology,neurosurgery,rehabilitation medicine,breast surgery,endocrinology and so on.Forty-six patients were diagnosed with "exposure keratitis" due to different causes(risk factors),including 10 patients with deep coma(10/46,21.75%)and 10 patients with generalized tracheal intubation(10/46,21.75%),10 patients with facial nerve palsy(10/46,21.75%),9patients with hyperthyroidism(9/46,19.55%),and 7 patients with eyeballs due to ocular tumors(7/46,15.2%).The Wilcoxon rank sum test was used to analyze the changes of corneal lesion score,visual acuity,effective rate and effective time after treatment for 3d,7d,14 d,21d and 30 d.The difference between the two groups was statistically significant.In the control group,the visual acuity improvement rate was53.8%.The visual acuity improvement rate was 95.5% in the experimental group;the effective rate was 56.2% in the control group and 93.3% in the experimental group;the average effective time in the control group was 7 days,and the average effective time in the experimental group was 5 day.In this study,patients with corneal bandages did notdevelop adverse events such as infectious keratitis,inflammatory infiltration,papillary conjunctivitis,dry eye and corneal neovascularization.Spearman rank correlation statistical analysis of the correlation between the corneal lesion score and the wear time of the corneal bandage lens in the experimental group,the correlation between the two is positively correlated,that is,the higher the score of the corneal lesion in the test group,the heavier the corneal lesion,the corneal bandage is worn during the treatment.The longer the mirror is.Untreated patients in both groups were stable after surgery.Conclusions:The study found that the use of PureVision corneal bandage mirror to assist conventional drug therapy is more effective than drug therapy alone,and the former shortens the healing time compared with the latter,thereby reducing the mental and economic burden of patients and improving the quality of life of patients.In addition,the higher the score of the corneal lesion,the heavier the corneal lesion,and the longer the period of wearing the corneal bandage mirror during treatment.However,due to the small sample size of this study,all the above conclusions are still to be further verified and supported by the large sample data.