不同术式治疗原发性翼状胬肉的临床效果分析

目的:比较分析羊膜移植术、自体角膜缘干细胞移植术及术中应用0.2g/L丝裂霉素C治疗原发性翼状胬肉的临床效果。方法:回顾性分析我院232例曾行原发性翼状胬肉手术的患者,其中82例行羊膜移植术治疗,90例行自体角膜缘干细胞移植术治疗,60例在术中应用0.2g/L丝裂霉素C治疗,比较三种术式术后复发率及并发症。结果:自体角膜缘干细胞移植术和术中应用0.2g/L丝裂霉素C治疗原发性翼状胬肉的复发率低于羊膜移植术(P<0.05);而自体角膜缘干细胞移植术和术中应用0.2g/L丝裂霉素C之间复发率无差异(P>0.05)。角膜上皮缺损,流泪和畏光在0.2g/L丝裂霉素组发生比例较其他两组高(P<0.05),在自体角膜缘干细胞移植组和羊膜移植组两组间差异无统计学意义(P>0.05)。结膜充血及结膜下出血在三组间无统计学差异(P>0.05)。结论:与其他两种术式相比,自体角膜缘干细胞移植术治疗原发性翼状胬肉,有着复发率低、并发症少的优点。

Clinical effect analysis of different surgical treatment of primary pterygium

AIM: To compare and analyze the clinical treatment effect of primary pterygium with amniotic membrane transplantation, autologous corneal limbus stem cell transplantation and intraoperative application of 0.2g/L mitomycin C.

METHODS: Retrospective analysis of 232 patients who were underwent primary pterygium surgery was performed. Eighty-two cases were treated with amniotic membrane transplantation, 90 with autologous corneal limbus stem cell transplantation, and 60 with intraoperative application of 0.2g/L mitomycin C. The postoperative recurrence and complications of three operative methods were compared.

RESULTS: The recurrence rate of autologous corneal limbus stem cell transplantation and intraoperative application of 0.2g/L mitomycin C was lower than that of amniotic membrane transplantation(P<0.05). The recurrence rate between autologous corneal limbus stem cell transplantation and intraoperative application of 0.2g/L mitomycin C had no difference(P>0.05). Corneal epithelium defect, tears and photophobia were higher in 0.2g/L mitomycin C group(P<0.05), which were no statistical difference between autologous corneal limbus stem cell transplantation and amniotic membrane transplantation(P>0.05). Conjunctival congestion and subconjunctival hemorrhage in three groups had no statistical difference(P>0.05).

CONCLUSION: Compared with other two operative methods,autologous corneal limbus stem cell transplantation for primary pterygium has the advantages of lower recurrence rate and less complications.