翼状胬肉切除联合Ologen胶原基质植入与自体结膜瓣移植术的疗效及安全性

目的：分析翼状胬肉切除联合Ologen胶原基质植入与翼状胬肉切除联合自体结膜瓣移植术后的疗效及安全性。

方法：选取我院2017-01/2020-01收治的翼状胬肉患者80例87眼，随机分为观察组(40例44眼，接受翼状胬肉切除联合Ologen胶原基质植入术)与对照组(40例43眼，接受翼状胬肉切除联合自体结膜瓣移植术)。随访至术后12mo，比较两组患者最佳矫正视力、角膜散光度、表面不对称指数(SAI)、表面规则指数(SRI)、角膜上皮愈合、翼状胬肉复发及并发症发生情况。

结果：两组术后6、12mo时视力变化情况均无差异(P>0.05)； 两组术后1、3mo时角膜散光度、SAI、SRI较术前均显著下降，观察组术后3mo时角膜散光度及术后1、3mo时SAI、SRI显著低于对照组(均P<0.05)； 观察组术后1wk时角膜上皮愈合率显著高于对照组(73% vs 46%，P<0.05)，至术后2wk两组角膜上皮均愈合； 两组术后12mo内未见翼状胬肉复发，术后6、12mo时翼状胬肉复发情况均无差异(P>0.05)； 两组术后并发症发生率无差异(7% vs 14%，P>0.05)。

结论：翼状胬肉切除联合Ologen胶原基质植入与翼状胬肉切除联合自体结膜瓣移植术治疗翼状胬肉均可获得可靠的疗效，且安全性相当，但前者在改善角膜散光度、角膜创面规则形态上优势更显著，更利于角膜创面恢复规则形态。

Efficacy and safety of pterygium resection respectively combined with Ologen collagen matrix implantation and autologous conjunctival flap transplantation

AIM:To analyze the efficacy and safety of pterygium resection respectively combined with Ologen collagen matrix implantation and autologous conjunctival flap transplantation.

METHODS:A total of 80 patients(87 eyes)with pterygium admitted to the hospital between January 2017 and January 2020 were selected, and randomly divided into observation group(40 patients, 44 eyes)treated with pterygium resection combined with Ologen collagen matrix implantation and control group(40 patients, 43 eyes)treated with pterygium resection combined with autologous conjunctival flap transplantation. The patients were followed up till 12mo after operation. The best corrected visual acuity, corneal astigmatism, surface asymmetry index(SAI), surface regularity index(SRI), corneal epithelial healing, pterygium recurrence and the incidence of complications were compared between the two groups.

RESULTS:Visual changes of the two groups were similar at 6 and 12mo after operation(P>0.05). Corneal astigmatism, SAI and SRI were reduced in the two groups at 1 and 3mo after operation. The corneal astigmatismat 3mo after operation and SAI, SRI at 1 and 3mo after operation were significantly lower in the observation group than in the control group(all P<0.05). The corneal epithelial healing rate in observation group at 1wk after operation was significantly higher than that in the control group(73% vs 46%, P<0.05), and corneal epithelium of the two groups healed at 2wk after operation. No pterygium recurrence was observed in the two groups within 12mo after operation. The situation of pterygium recurrence was similar in the two groups at 6 and 12mo after operation(P>0.05). There was no significant difference in the incidence of complications between the two groups(7% vs 14%, P>0.05).

CONCLUSION:Both pterygium resection combined with Ologen collagen matrix implantation and pterygium resection combined with autologous conjunctival flap transplantation are effective in the treatment of pterygium, with equivalent safety. However, the former has more advantages in improving corneal astigmatism and regular shape of corneal wound.