角膜缘自体结膜移植和羊膜移植治疗原发性翼状胬肉的疗效

目的：观察角膜缘自体结膜移植和羊膜移植治疗原发性翼状胬肉的临床效果。

方法：选取2013-01/2015-12深圳人民医院收治的翼状胬肉患者96例96眼，依据手术方式分为两组，其中LCAT组46例46眼，行翼状胬肉切除联合角膜缘自体结膜移植术； AMT组50例50眼，行翼状胬肉切除联合羊膜移植术。比较两组患者手术用时，术后随访12mo，比较两组角膜上皮修复所需时间、术后并发症以及复发情况。

结果：LCAT组和AMT组手术用时分别为33.83±1.65、23.60±1.51min，LCAT组高于AMT组，差异有统计学意义(t=-31.683，P<0.001)。LCAT组和AMT组术后角膜上皮修复所需时间分别为4.04±0.95、4.67±1.18d，LCAT组低于AMT组，差异有统计学意义(t=-2.922，P=0.004)； LCAT组复发1例1眼，复发率2%，AMT组复发3例3眼，复发率6%，两组复发率比较，差异无统计学意义(P=0.618)。LCAT组术后2wk术区发生结膜肉芽肿1例1眼，AMT组术后未见严重并发症。

结论：角膜缘自体结膜移植术和羊膜移植术治疗原发性翼状胬肉术后恢复快，并发症少，复发率低，是安全有效的手术方式。

Clinical effect of limbal conjunctival autograft or amniotic membrane transplantation for the treatment of primary pterygium

AIM: To observe the clinical effect of limbal conjunctival autograft transplantation(LCAT)or amniotic membrane transplantation(AMT)in treatment of primary pterygium.

METHODS: Analysis of 96 cases(96 eyes)with primary pterygium treated at Shenzhen People''s Hospital from January 2013 to December 2015 was taken. Depending on the surgical methods, the patients were divided into two groups: excision of pterygium and limbal conjunctival autograft transplantation being performed in LCAT group(46 cases, 46 eyes); excision of pterygium and amniotic membrane transplantation being performed in AMT group(50 cases, 50 eyes). Two groups were followed-up for 12mo to compare the operation time, the corneal epithelium repair time, postoperative complications and the recurrence rate.

RESULTS: The operation time of LCAT and AMT group was 33.83±1.65min, 23.60±1.51min respectively, the LCAT group was higher than the AMT group(t=-31.683, P<0.001). The corneal epithelium repair time of LCAT and AMT group was 4.04±0.95d, 4.67±1.18d respectively, the LCAT group was lower than the AMT group(t=-2.922, P=0.004); 1 case was recurred in LCAT group, 3 cases were recurred in AMT group. The recurrence rate was 2% in LCAT group and 6% in AMT group, but it hadn''t show a significant statistical difference between the two groups(P=0.618). One case of conjunctival granuloma was observed in 2wk after surgery of LCAT group, but no serious complications were observed in AMT group.

CONCLUSION: Limbal conjunctival autograft transplantation and amniotic membrane transplantation are effective and safe methods to primary pterygium, which have advantages of rapid recovery, fewer complications and the lower recurrence rate.