滑行移植自体角膜缘干细胞联合丝裂霉素C治疗翼状胬肉

目的:研究自体角膜缘干细胞滑行移植联合丝裂霉素C治疗翼状胬肉的临床疗效。方法:选择我科翼状胬肉住院手术患者79例89眼,随机分成两组,治疗A组40例45眼和对照B组39例44眼,两组均行翼状胬肉切除,滑行移植自体角膜缘干细胞修复暴露的巩膜创面,而治疗A组在移植之前使用MMC。随访1a,观察复发率及并发症。结果:治疗A组45眼复发1眼,复发率为2%,对照B组44眼复发6眼,复发率为14%,两组相比较差异具有显著的统计学意义(P<0.05)。治疗A组出现持续性角膜上皮缺损1眼,治疗5d后修复,有4眼畏光、流泪、疼痛较重,结膜延迟愈合3眼(12～15d);对照B组移植片轻度水肿3眼,创面肉芽生长1眼,有1眼畏光、流泪、疼痛较重。并发症两组相比较差别无统计学意义(P>0.05)。结论:自体角膜缘干细胞滑行移植联合丝裂霉素C治疗翼状胬肉复发率低,术后恢复快、并发症少。

Sliding transplantation of auto-corneal limbus stem cell combined with mitomycin C for pterygium treatment

AIM: To evaluate the efficacy of sliding transplantation of auto-corneal limbus stem cell combined with mitomycin C(MMC)on pterygium treatment.

METHODS: Totally, 79 patients(89 eyes)who received treatment at our hospital were selected. Eighty-nine eyes of 79 patients with pterygium were randomly divided into two groups: 40 patients(45 eyes)in group A underwent sliding limbal autograft transplantation with MMC and 39 patients(44 eyes)in group B underwent simple limbal autograft transplantation. Recurrence rate and complications were observed during the 12-month follow-up.

RESULTS: One of 45 eyes(2%)of group A and six of 44 eyes(14%)in group B were recurrent with significant difference(P<0.05). One eye with corneal epithelium damage was observed in group A, it was healed with treatment after 5 days. Photaesthesia, lachrymation and pain were relevantly severe in 4 eyes, and 3 eyes displayed delayed union in conjunctival wounds(12-15 days). In B group, 3 eyes slight edema of grafts, 1 eye was growth of a wound granulation, and 1 eye was relevantly severe in photaesthesia, lachrymation and pain. Complications compared two groups had no significant difference(P>0.05).

CONCLUSION: Sliding transplantation of auto-corneal limbus stem cell combined with MMC for pterygium had advantages of lower recurrence rate, rapid recovery and less complications.