邻近角巩膜缘结膜移植治疗翼状胬肉

目的:评价利用邻近角巩膜缘结膜瓣重建翼状胬肉术后角巩膜缘的手术方法。方法:对100例翼状胬肉手术进行了前瞻性非随机对照研究,局麻下行翼状胬肉切除术。切除后,切口两侧带有临近角巩膜缘组织的两个结膜瓣切开后缝合,重新恢复角结膜缘。角巩膜缘重建结果用印迹细胞学方法评价。结果:印迹细胞学方法证实角巩膜缘完全重建。随访6-24(平均14)mo,术后复发率为4%。两位手术者所做手术后复发率差异小(3%vs4%)。在复发的病例中发现,包括粘液细胞增生和鳞状化生的角巩膜缘解剖结构改变。结论:角巩膜缘邻近的结膜瓣移植术是一种安全简单的翼状胬肉手术方法,可以完全重建角巩膜缘,术后复发率低。

Adjacent limbal transplantation for pterygium treatment

AIM:To evaluate a technique of limbal reconstruction for pterygium through surgery using flaps of adjacent limbal conjunctiva.METHODS:As for a prospective non-comparative case series of 100 pterygium surgeries,pterygium resection was performed with topical anesthesia.Once resected,two adjacent flaps of conjunctiva with the adjoining limbus were dissected and then sutured,reassembling the corneo-conjunctival limbus.Limbal reconstruction was evaluated with impression cytology.RESULTS:Complete reconstruction of the limbus was documented with impression cytology.A recurrence rate of 4% was observed with this technique,during follow-up of 6 to 24 months(with a mean of 14 months) .There was a minimal difference between surgeons(3% vs 4%) .Loss of limbal anatomy with mucous hyperplasia and squamous metaplasia was documented during recurrences.CONCLUSION:Adjacent limbal transplantation is a safe and simple technique for pterygium surgery and complete reconstruction of limbus is documented,with a minimal rate of recurrence.