翼状胬肉切除联合角膜缘干细胞移植及术后药物治疗临床观察

目的:观察翼状胬肉切除联合角膜缘干细胞移植及术后药物治疗翼状胬肉的临床疗效。方法:共行翼状胬肉切除联合角膜缘干细胞移植术治疗的翼状胬肉患者760例980眼。选取亚复发期的162例162眼进行观察,随机分为A,B两组,A组滴1g/L丝裂霉素C+诺氟沙星滴眼液1～3mo;B组交替滴地塞米松滴眼液、双氯芬酸钠滴眼液1～3mo。结果:A组痊愈67眼(81.7%),亚复发12眼(14.6%),复发3眼(3.7%)。B组痊愈35眼(43.8%),亚复发29眼(36.3%),复发16眼(20.0%)。A组复发率明显低于B组(P<0.01)。结论:翼状胬肉切除联合自体角膜缘干细胞移植术,无排斥反应、安全有效、术后复发率低,术后给予滴眼液后续治疗尤为重要,更能有效地抑制和降低翼状胬肉术后的复发率,能明显提高治疗效果。

Clinical observation of pterygium excision combined with limbal stem cell transplantation and drug therapy

AIM: To investigate the effect of pterygium excision combined with autologous limbal stem cell transplantation and drug treatment after the operation.

METHODS: A total of 980 eyes of 760 cases underwent pterygium excision, the conjunctival graft with stem cells was interrupted sutured in the limbal sclera planting beds and bulbar conjunctiva. One hundred and sixty-two eyes which relapse again were divided into 2 groups, group A: 1g/L mitomycin C+norfloxacin eye drops for 1-3 months; Group B: dexamethasone eye drops and diclofenac sodium eye drops for 1-3 months or more.

RESULTS: One hundred and sixty-two eyes which relapse again were divided into the A and B groups use different medication treatment, Group A: 67 eyes(81.7%)were curd, 12 eyes(14.6%)relapse again, 3 eyes(3.7%)recurrence. Group B: 35 eyes(43.8%)were cured, 29 eyes(36.3%)relapse again, 16 eyes(20.0%)recurrence. The recurrence rate of group A was significantly lower than that of group B(P<0.01).

CONCLUSION: Pterygium excision combined with limbal stem cell transplantation without rejection, safe and effective, with low recurrence rate, postoperative eye drops is particularly important, which could effectively inhibit and reduce the recurrence rate and significantly improve the therapeutic effect.