复合式与单纯翼状胬肉切除术的对比观察

目的 比较复合式翼状胬肉切除术和单纯翼状胬肉切除术的临床疗效.方法 将227例(251只眼)原发性翼状胬肉患者随机分成2组:复合式翼状胬肉切除术组114例(123只眼),单纯翼状胬肉切除术组113例(128只眼).复合式切除术组联合应用丝裂霉素C和角膜缘干细胞移植,其他手术操作步骤与单纯翼状胬肉切除术组基本相同.回顾性统计分析两种手术方式的术后复发率及并发症.结果 复合式翼状胬肉切除术组6只眼复发,复发率4.88％;单纯翼状胬肉切除术组35只眼复发,复发率27.34％.2组术后复发率差异有统计学意义.2组均未见严重的并发症.结论 胬肉切除、MMC联合角膜缘干细胞移植复发率低,手术安全,疗效可靠.     

保留Tenon’s囊的改良式翼状胬肉切除术的临床观察

目的:评价保留Tenon’s囊的改良式翼状胬肉切除联合角膜缘干细胞移植术的临床价值。方法:试验组单纯原发性翼状胬肉150例166眼行保留Tenon’s囊的改良式翼状胬肉切除联合角膜缘干细胞移植术,对照组单纯原发性翼状胬肉患者136例146眼行传统去除Tenon’s囊的翼状胬肉切除联合角膜缘干细胞移植术。观察两组患者手术持续时间、术后结膜充血时间、角膜上皮生长时间、BUT(泪膜破裂时间)、SIt(泪液分泌试验)、复发率,问卷调查了解术后疼痛等主观不适。结果:A组手术时间(25.43±3.18)min,较B组(33.87±3.74)min明显缩短。两组BUT、SIt结果分析均显示,A组术后泪膜功能恢复较快。术后1个月A组结膜充血16例(10.7%),B组24例(17.6%),差异有统计学意义。术后1个月A组主观不适评分(0.21±0.36)分,B组(0.38±0.45)分,差异有统计学意义。术后角膜上皮修复和复发率两组无明显差异。结论:保留Tenon’s囊的改良式翼状胬肉切除联合角膜缘干细胞移植术在角膜上皮修复时间及复发率方面与传统术式并无显著差异,但改良术式能显著缩短手术持续时间、缩短泪膜功能恢复时间,且术后结膜充血时间更短,患者术后疼痛不适周期明显缩短,大大减轻患者痛苦,在临床应用中具备显著优势。     

翼状胬肉切除联合自体角膜缘干细胞移植治疗翼状胬肉的效果观察

目的观察基层医院开展翼状胬肉切除联合自体角膜缘干细胞移植术治疗翼状胬肉的临床疗效。方法对该院收治的66例（80眼）翼状胬肉患者随机分为观察组34例（40眼）和对照组32例（40眼）。观察组行翼状胬肉切除联合自体角膜缘干细胞移植术,对照组行单纯翼状胬肉切除,比较两种手术方式的治愈率。结果通过对观察组和对照组患者术后疗效比较和随访,观察组治愈率（92．5％）明显高于对照组（67．5％）（P〈0．05）。结论翼状胬肉切除联合自体角膜缘干细胞移植术治疗翼状胬肉效果明显,复发率低,适合基层医院开展。     

较高浓度丝裂霉素C在胬肉切除术中的应用

目的：探讨防止初发性翼状胬肉切除后复发的手术方法。方法：使用0．04％丝裂霉素C结膜下贴敷5分钟，再用100ml生理盐水冲洗。结果：23例25眼术后仅1眼复发，均无巩膜结膜溃疡发生。结论：该手术可能是效果较好的翼状胬肉切除术。     

翼状胬肉患者的循环免疫复合物

用C_3b致敏酵母菌凝集试验测定35例翼状胬肉患者(其中进行期22例,静止期13例)和30例对照组血中循环免疫复合物。结果发现与对照组相比,翼状胬肉患者血中循环免疫复合物明显增多,进行期较静止期也明显增多,提示全身免疫系统可能参与了翼状胬肉发病。     

保存羊膜联合自体角膜缘干细胞移植治疗复发性翼状胬肉

目的：评价保存羊膜联合自体角膜缘干细胞移植治疗复发性翼状胬肉的临床效果。方法：对8例8眼复发性翼状胬肉行胬肉切除联合保存羊膜联合自体角膜缘干细胞移植手术。结果：随访患者6～22个月。无1例复发。结论：保存羊膜联合自体角膜缘干细胞移植是治疗复发性翼状胬肉的有效方法。     

自体角膜缘干细胞移植联合丝裂霉素C治疗翼状胬肉

目的 探讨自体角膜缘干细胞移植联合丝裂霉素C治疗翼状胬肉的疗效。方法 将22眼翼状胬肉患者分为治疗组和对照组，对照组行单纯胬肉切除，治疗组采用单纯胬肉切除加自体角膜缘干细胞移植联合0．2mg/ml丝裂霉素C术。结果 治疗组成功率100％，无复发、无脱落及排斥反应，明显优于对照组。结论 自体角膜缘干细胞移植联合丝裂霉素C治疗翼状胬肉可明显降低术后复发率。     

Postoperative beta radiation treatment of pterygium

A retrospective analysis of 69 patients with diagnosis of pterygium who underwent surgical removal of the pterygium and postoperative beta radiation from a Strontium-90 (Sr-90) applicator from January, 1973, to December, 1977, is presented. The radiation treatment was delivered 2–48 hrs postoperatively after surgical removal of the pterygium. Those few patients who received beta radiation after more than 56 hours postoperatively were not included in the analysis because of the small number of patients in this group. Thirty-two patients had bilateral pterygium; 18 patients from this group received radiation treatment to one eye only. A total of 83 eyes have been irradiated in the whole group. A total dose of 1800–2200 rad equivalent of beta radiation was delivered to the edge of the cornea and surgical bed of the pterygium in the conjunctiva. Measurement by phantom showed that the dose to the anterior surface of the lens will be approximately 70–90 rad, and the dose to the retina will be 4–8 rad during a single dose of 1800–2200 rad equivalent of beta radiation to the conjunctiva and pterygium bed. Thirty-nine percent of the nonirradiated eyes after removal of the pterygium developed recurrence, whereas only 5% of the irradiated eyes developed recurrence. Nineteen percent of the irradiated eyes developed cataract as well as 10% of the nonirradiated eyes. These include all detectable cataracts, some of which did not require lens removal. Local cortisone therapy reduced the progression of the recurrent disease for a few months and partial regression was seen in four eyes, but there was no complete regression of any recurrent pterygium with topical cortisone therapy. This retrospective study showed that postoperative 1800–2200 rad beta radiation from a Strontium-90 applicator, if delivered 2–48 hours postoperatively, is effective in reducing the recurrence rate. It has acceptable range of complication if it is administered by an experienced radiation therapist and calculation and calibration are done precisely. The immediate and late side effects and complications of beta radiation from a Strontium applicator are discussed, and the dose delivered to the cornea, sclera, lens, and retina with this radiation treatment are shown.     

Photodynamic therapy for wound-healing modulation in pterygium surgery. A clinical pilot study

Background This study was performed to evaluate the safety and efficacy of photodynamic therapy with the carboxyfluorescein ester BCECF-AM as an adjunctive treatment procedure for pterygium surgery to reduce the rate of recurrence.Methods In this nonrandomized prospective clinical trial, 19 eyes with nasally located primary pterygium were examined. All eyes were treated with the bare sclera surgical technique. Seven eyes received in addition treatment with BCECF-AM solution and blue light. All patients were evaluated at least after 1 day, 1 week, 1 month, 3 months, and 1 year. Postoperative fibrovascular growth from the limbus of at least 1 mm was defined as recurrence.Results The intraoperative application of BCECF-AM solution did not cause anterior chamber flare or any other significant side effects. The bare sclera surgery rate of recurrence was 0% (zero of 12) after 3 months and 91% (11 of 12) after 1 year. The additional photodynamic therapy treatment had a rate of recurrence of 14.2% (one of seven) after 3 months and 71.4% (five of seven) after 1 year.Conclusions The applied PDT technique seems to be a safe procedure but is associated with a high rate of recurrence. In conclusion, the evaluated PDT treatment procedure, at this point, should not be considered. As we found a high rate of recurrence also in the control group, the bare sclera technique is not effective, even in primary pterygia.     

三种方法治疗112例翼状胬肉的临床效果观察

目的观察单纯翼状胬肉切除、胬肉切除联合丝裂霉素治疗与胬肉切除加自体角膜缘上皮联合球结膜移植治疗翼状胬肉的临床疗效。方法选择符合手术标准的翼状胬肉患者93例112只眼,分为A（38眼）、B（38眼）、C（36眼）三组。A组翼状胬肉单纯切除,B组胬肉切除联合丝裂霉素治疗,C组胬肉切除加自体角膜缘上皮联合球结膜移植。观察三组术后角结膜愈合情况以及胬肉复发率。结果随访12～30月,复发率A组23.68%,B组10.53%,C组无复发病例。C组与A、B组比较,差异均有统计学意义（P〈0.05）。结论 胬肉切除加角膜缘干细胞联合结膜移植是处理胬肉复发的最佳方式。该手术较简便,成功率高,复发率低。