角膜缘干细胞移植术治疗原发性翼状胬肉

目的：评价自体角膜缘干细胞移植治疗原发性翼状胬肉的安全性和有效性。

方法：前瞻性观察性研究。采用自体角膜缘干细胞移植术治疗鼻侧原发性翼状胬肉264例(男性142例，女性122例)。患者平均年龄54.22±15.24岁。翼状胬肉术后1、3、7d及1、3、6、9、12、36mo进行定期随访。评估手术时间，角膜上皮愈合时间，术后复发率和手术并发症。

结果：平均手术时间为25.7±2.6min。经过至少3a的术后随访，术后角膜上皮愈合时间为3.85±0.72d。14例患者出现眼科并发症。本研究未发现虹膜睫状体炎、睑球粘连、角膜溃疡等威胁视力的严重并发症。结膜移植片水肿5例，肉芽肿形成3例，结膜下血肿6例。随访3a，11例患者复发，复发率为4.17%，首次出现复发时间为3mo，平均8mo。

结论：经长期随访，自体角膜缘干细胞移植术无严重并发症，复发率低，是治疗原发性翼状胬肉安全有效的方法。我们还建议对于原发性翼状胬肉手术，12mo的术后随访为最佳时间。

Limbal stem cell transplantation for primary pterygium

AIM: To evaluate the safety and efficacy of limbal conjunctival autograft transplantation for treating primary pterygium over a period of 3y.

METHODS: Prospective observational consecutive case series. In this study, 264 eyes of 264 patients(142 males and 122 females)with nasal primary pterygium were treated using the technique of limbal conjunctival autograft. The mean ages of the patients were 54.22±15.24a. After excision of the pterygium patients were followed up on 1, 3, 7d and at 1, 3, 6, 9, 12 and 36mo. Recurrence of pterygium, complications, operation time and corneal epithelialization time were evaluated.

RESULTS: The average surgery time was 25.7±2.6min. With a minimum 3-year of follow-up, postoperative corneal epithelialization was completed in 3.85±0.72d. Complications were observed in 14 cases. Vision-threating complications such as iritis, scleral thinning symblepharon or ulceration were not detected in the study. 5 eyes with graft edema, 3 eyes with granuloma formation and 6 cases with a subconjunctival hematoma in the nasal conjunctiva. By the end of 3-year follow-up, recurrence was detected in 11 cases. The recurrence rate was 4.17%, and the onset of recurrence was 3mo, the average recurrence time was 8mo.

CONCLUSION: There were no severe complications and few recurrences when limbal conjunctival autograft transplantation was performed after long-term follow-up, we suggest that limbal conjunctival autograft transplantation is a safe and effective technique in primary pterygium. We also recommend that 12-month follow-up is optimal on primary pterygium surgery.