富血小板纤维蛋白移植在翼状胬肉切除术中的应用

目的:比较富血小板纤维蛋白(PRF)移植和自体角膜缘干细胞移植应用于翼状胬肉切除术的效果。方法:将62例62眼原发性翼状胬肉随机分为第1组(32眼)和第2组(30眼),翼状胬肉切除后,第1组用自体角膜缘干细胞作为移植物,第2组用PRF作为移植物覆盖裸露巩膜。PRF通过术前抽取患者自身静脉血后离心和压制制得。术后随访6mo,评估手术时间、并发症和复发率,并进行组间比较。结果:第1组和第2组的平均手术时间分别为27.3±4.3、22.0±4.0min,两组有差异(t=4.990,P<0.01)。术后第1组未出现肉芽肿,第2组出现肉芽肿1眼,两组无差异(P=0.484)。第1组和第2组术后均复发1眼,两组无差异(P=1.000)。第1组和第2组术前眼压分别为14.69±2.44、14.96±2.93mmHg,两组无差异(t=0.399,P=0.691)。第1组和第2组术后眼压分别为14.68±1.65、15.11±2.12mmHg,两组无差异(t=0.888,P=0.378)。PRF移植组术后PRF膜溶解时间为3.5±0.8d。结论:PRF移植应用于翼状胬肉切除术安全有效,操作更加简单省时,是一种有临床应用前景的方法。

Application of platelet-rich fibrin grafts in pterygium excision

AIM: To compare the effect of platelet-rich fibrin(PRF)grafts and conjunctival-limbal autografts in pterygium excision.

METHODS: Totally 62 cases(62 eyes)of primary pterygium were randomly divided into group 1(32 eyes)and group 2(30 eyes). After pterygium excision, conjunctival-limbal autografts was performed in group 1 and PRF grafts was performed in group 2. PRF was prepared by centrifugation and compression of venous blood from patients before the surgery. The follow-up period was 6mo. The surgery time, complications and recurrence rate were evaluated and compared between the two groups.

RESULTS: The operation time of group 1 and group 2 were 27.3±4.3min and 22.0±4.0min respectively. There was significant difference between the two groups(t=4.990, P<0.01). Conjunctival granuloma developed only in one eye in group 2 after the surgery, and there was no significant difference between group 1 and group 2(P=0.484). Pterygium recurred in one eye in group 1 and in one eye in group 2. There was also no significant difference in recurrence rate between group 1 and group 2(P=1.000). There was no significant difference in intraocular pressure between group 1 with 14.69±2.44mmHg and group 2 with 14.96±2.93mmHg before the surgery(t=0.399, P=0.691). As well, there was no significant difference in intraocular pressure between group 1 with 14.68±1.65mmHg and group 2 with 15.11±2.12mmHg after the surgery(t=0.888, P=0.378). The dissolution time of PRF membrane in PRF grafts group was 3.5±0.8d.

CONCLUSION: The use of PRF in pterygium surgery is safe, effective, easier and timesaving. It''s a promising method for clinical application.