生物羊膜联合带自体角膜缘干细胞的结膜瓣移植治疗伴睑球粘连的复发性翼状胬肉

目的:观察生物羊膜联合带自体角膜缘干细胞的结膜瓣移植治疗伴睑球粘连的复发性翼状胬肉的临床效果。方法:将68例76眼伴睑球粘连的复发性翼状胬肉患者按年龄、性别、翼状胬肉大小、睑球粘连程度分为A,B两组,A组30例34眼为翼状胬肉切除加生物羊膜移植组,B组38例42眼为翼状胬肉切除加生物羊膜联合带自体角膜缘干细胞的结膜瓣移植组。术后随访6～24mo。观察角膜透明程度,新生血管的有无,胬肉复发及睑球粘连复发情况。结果:A组有不同程度角膜云翳21眼(62%),其中9眼(26%)伴新生血管,4眼(12%)胬肉复发,1例睑球粘连复发。B组有不同程度角膜云翳9眼(21%),其中3眼(7%)伴新生血管,2眼(5%)胬肉复发,无睑球粘连复发患者。两组比较有角膜云翳及新生血管的发生率有显著性差异,复发率无显著性差异。结论:生物羊膜联合带自体角膜缘干细胞的结膜瓣移植治疗伴睑球粘连的复发性翼状胬肉是一种较理想的治疗方法。

Biological amnion combined with conjunctival flap with limbus stem cell transplant in the treatment of recurrent pterygium complicated with symblepharon

AIM:To observe the clinical effect of biological amnion combined with conjunctival flap with limbus stem cell transplant in the treatment of recurrent pterygium complicated with symblepharon. ·METHODS:Sixty-eight cases(76 eyes) with symblepharon and recurrent pterygium were divided into two groups according to age,gender,pterygium size and degrees of symblepharon.Group A:30 cases(34 eyes) underwent pterygium excision and biological amnion transplant. Group B:38 cases(42 eyes) underwent pterygium excision and biological amnion combined with conjunctival flap with limbus stem cell transplant. The follow-up time was 6 to 24 months. The degree of corneal transparency,availability of neovascularization and recurrence rate of pterygium and symblepharon was observed. ·RESULTS:The number of eyes with corneal nebula,neovessels,pterygium recurrence and symblepharon recurrence was 21,9,4,1 respectively,and the rate of the first three was 62%,26%,12%,respectively in group A. The number of eyes with corneal nebula,neovessels,pterygium recurrence and symblepharon recurrence was 9,3,2 respectively,and the rate was 21%,7%,5%,respectively in group B.And there was no symblepharon recurrence case. ·CONCLUSION:Biological amnion combined with conjunctival flap with limbus stem cell transplant in the treatment of recurrent pterygium complicated with symblepharon was an ideal therapeutic method.