目的：探讨硅水凝胶软性角膜接触镜治疗持续性角膜上皮缺损的疗效。

方法：回顾性分析2014-01/2017-01我院收治的持续性角膜上皮损伤患者56例56眼病例资料，其中21例配戴水凝胶材质角膜接触镜者纳入对照组，35例配戴硅水凝胶软性角膜接触镜治疗者纳入观察组，观察临床疗效、角膜混浊分级、视力改善、患者主观舒适度及并发症情况。

结果：两组患者临床疗效差异有统计学意义(P=0.042)，且观察组总有效率明显较对照组高(94% vs 76%)。治疗后3d组间haze分级差异无统计学意义(P>0.05)； 治疗1wk，1mo后组间haze分级差异均有统计学意义(P<0.05)，且治疗1mo后观察组haze分级0级所占比例明显较对照组高(49% vs 19%)，组间差异有统计学意义(χ²=4.881，P=0.027)。治疗后1mo两组患者视力改善差异有统计学意义(Z=-3.347，P<0.05)，观察组91.43%患者视力提高，明显高于对照组的52.38%(P=0.002)。治疗前两组舒适度评分差异无统计学意义(P>0.05)； 治疗后第1d两组患者舒适度评分均增加，且观察组治疗后1、3d，1wk舒适度评分均显著低于对照组，差异均有统计学意义(t=-17.422、-15.827、-16.588，均P<0.01)。观察组角膜上皮愈合时间平均为4.25±1.05d，对照组为5.96±2.16d，组间差异有统计学意义(t=-3.395，P<0.05)。观察组不良反应发生率较对照组低，组间差异有统计学意义(P<0.05)。

结论：硅水凝胶软性角膜接触镜可用于治疗持续性角膜上皮缺损。

METHODS: The clinical data of 56 patients(56 eyes)with persistent corneal epithelial defect treated in our hospital from January 2014 to January 2017 were retrospectively analyzed; 21 patients in the control group received hydrogel contact lenses, and 35 patients in the observation group received silicone hydrogel soft contact lens. Then the clinical effect, the classification of corneal opacity, the improvement of visual acuity, the subjective comfort and complications of the patients were recorded.

RESULTS: Wilcoxon rank sum test showed that there were significant differences in the clinical efficacy between the two groups(P=0.042). The total effective rate of the observation group was significantly lower than that of the control group(94% vs 76%). There was no significant difference in Haze classification between the groups after 3d of treatment(P>0.05); after 1wk and 1mo of treatment, there were significant differences in Haze classification between groups(P<0.05); after 1mo of treatment, the proportion of Haze grading 0 in the observation group was significantly higher than that in the control group(49% vs 19%), there was significant difference between the two groups(χ²=4.481, P=0.027). There was a significant difference in visual acuity between the two groups(Z=-3.347, P<0.05); the visual acuity of 91.43% in the observation group were improved, which was significantly lower than that of the control group(52.38%, P=0.002). There was no significant difference in the comfort scores between the two groups before treatment(P>0.05). After the first day of treatment, the comfort scores of both groups increased. The comfort scores of the observation group after treatment 1d, 3d and 1wk were significantly lower than those of the control group(t=-17.422, -15.827, -16.588; P<0.01). The average healing time of corneal epithelium in the observation group was 4.25±1.05d, and the control group was 5.96±2.16d(t=-3.395, P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).

CONCLUSION: Silicon hydrogel soft corneal contact lens can be used in the treatment of persistent corneal epithelial defect.