自体角膜缘干细胞移植联合羊膜移植术治疗复发性翼状胬肉的临床研究

目的:了解自体角膜缘上皮干细胞移植联合羊膜移植术治疗复发性翼状胬肉的临床疗效。方法:82例(91眼)复发性翼状胬肉,随机分成3组,角膜缘上皮干细胞联合纯甘油保存羊膜移植组(联合组)31例(34眼);羊膜移植组(羊膜组)26例(30眼);角膜缘上皮干细胞移植组(干细胞组)25例(27眼)。进行定期随访观察疗效评价。结果:82例患者(91眼)术后随访时间4~31(平均15.30±8.31)mo。联合组31例(34眼),术后随访时间平均(15·43±8.31)mo,无1例复发;单纯羊膜组26例(30眼),术后随访时间平均(14.80±8.86)mo,有4眼复发,复发率为13%;单纯干细胞移植组25例(27眼),术后随访时间平均(15.58±8.06)mo,有3眼复发,复发率为11%。联合组与羊膜组及干细胞组的复发率(P<0.05)有显著性差异,而羊膜组与干细胞组的复发率无显著性差异。全部病例均无感染、排斥、复视和眼球运动障碍等并发症。结论:角膜缘上皮干细胞移植联合羊膜移植术是治疗复发性翼状胬肉最有效手术方法。特别对翼状胬肉多次复发患者或伴有睑球粘连患者应作为首选的治疗方法。

Limbal corneal epithelial stem cell autograft combined with amniotic membrane transplantation for patients with recurrent pterygium

AIM: To evaluate the therapeutic effect of limbal corneal epithelial stem cell autograft combined with amniotic membrane transplantation on patients with recurrent pterygium. ·METHODS: Eighty-two cases (91 eyes) with recurrent pterygium were randomly divided into 3 groups: excision of pterygium with limbal corneal epithelial stem cell autograft combined with amniotic membrane transplantation was as combine group 1 (31 cases, 34 eyes), amniotic membrane transplantation as amniotic membrane group (26 cases, 30 eyes) and limbal corneal epithelial stem cell autograft as stem cell group (25 cases, 27eyes). They were followed up at regular intervals. ·RESULTS: Eighty-two cases (91 eyes) were followed up for 4 to 31 months (average 15.30±8.31 months). In combine group (31 cases, 34 eyes), during postoperative terms of follow-up (average 15.43±8.31 months), no recurrent cases were found. Cases treated with amniotic membrane (26 cases, 30 eyes), within follow-up period (average 14.80±8.86 months), 4 (13%) eyes recurred. As for stem cell group (25 cases, 27 eyes), during postoperative terms of follow-up (average 15.58±8.06 months), three (11%) recurrent cases were found. There was significant difference among 3 groups, but there was no difference between amniotic membrane group and stem cell group. In the term of follow-up, no infection, repulsion, diplopia or moving obstacle of eye-ball were found in all cases. ·CONCLUSION: Limbal corneal epithelial stem cell autograft combined with amniotic membrane transplantation is the most effective way on recurrent pterygium treatment. ·