翼状胬肉扩大切除联合自体角膜缘干细胞移植术的临床疗效观察

目的:探讨翼状胬肉扩大切除联合自体带结膜瓣的角膜缘干细胞移植术的手术方法及其临床疗效。方法:选择达到或超过瞳孔缘的35例36眼翼状胬肉患者,其中有4眼为复发性,其余均为原发性,于显微镜下做扩大的翼状胬肉切除,包括变性的球筋膜,联合自体带结膜瓣的角膜缘干细胞移植术,术后随访6～24.4mo,中位数为14.6mo,观察术眼手术前后视力变化及术后复发情况。结果:术前视力为指数/眼前～0.6,中位数为0.25,术后1mo视力为指数/眼前～1.2,中位数为0.7(秩和检验u=5.325,P<0.01)。无1例术后复发,复发率为0。结论:翼状胬肉扩大切除联合自体带结膜瓣的角膜缘干细胞移植术,术后复发率低,视力提高显著,是治疗翼状胬肉的有效方法,其术后的长期疗效仍需进一步观察。

Clinical effect of enlarged excision of pterygium combined with autologous corneal limbal stem cell transplantation

AIM:To evaluate the methods and curative effect of the enlarged excision of pterygium combined with autologous corneal limbal stem cell transplantation with conjunctival flap. ·METHODS:Thirty-five patients (36 eyes) with pterygium reaching or surpassing the pupil margin were studied. 4 eyes were recurrent pterygium,the others were initial,and all the patients underwent the microsurgery of excision of pterygium including the degenerating bulbal foscia,combined with autologous corneal limbal stem cell transplantation with conjunctival flap. The post-operative follow up period was 6-24.4 months; the median was 14.6 months;and the change of visual acuity and the recu-rrence rate were observed after surgery. ·RESULTS:The post-operative visual acuity was counting finger to 1.2,the median was 0.7 (rank test,u=5.325,P<0.01). No eye recurred. ·CONCLUSION:The enlarged excision of pterygium combined with autologous corneal limbal stem cell transplantation seems to be an effective treatment for pterygium with low recurrence rate and better visual acuity,and further research is necessary to observe the long term effect after surgery.