角膜缘干细胞移植与羊膜移植及单纯胬肉切除治疗复发性翼状胬肉的疗效比较

目的 比较自体角膜缘干细胞移植与新鲜羊膜移植及单纯胬肉切除治疗复发性翼状胬肉的疗效.方法 对复发性翼状胬肉166例(176只眼),随机分为A、B、C 3组,A组67例,72只眼,行复发性翼状胬肉切除联合自体角膜缘干细胞移植术.B组58例,59只眼,行复发性翼状胬肉切除联合新鲜羊膜移植术.C组43例,45只眼,行单纯胬肉切除.手术后随访6～60个月.比较3组患者的症状,创伤愈合情况,胬肉复发情况.结果 A组72只眼中年复发28只眼,复发率39%,B组59只眼中复发28只眼,复发率47.5%.C组45只眼中复发39例,复发率86.6%.结论 自体角膜缘干细胞移植与新鲜羊膜移植较单纯胬肉切除明显降低复发性翼状胬肉手术后复发率.而自体角膜缘干细胞移植比新鲜羊膜移植更有效降低复发性翼状胬肉的复发率.

Clinical observatiom of corneal limbal stem cell auto-grafting,the transplantation of anmion and the pure removal of pterygium to treat the recurrent pterygium

Objective The effect analyses by comparing and observing corneal limbal stem cell auto-grafting,the transplantation of flesh amnlon and the pure removal of pterygium to treat the recurrent pterygium.Method 166 cases of recurrent Pterygium( 176 eyes)is divides into 3 groups(named A,B,and C) randomly.Group A (with 67 cases, 72 eyes)is operated by removing the recurrent pterygium and corneal limbal stem cell auto-grafting.Group B (with 58 cases,59 eyes)is operated by removing the recurrent pterygium and the transplantation of flesh amnion.Group C (with 43 eases,45 eyes)is only operated by removing the pterygium.After operation,visits lasting 6-60 months are followed and comparations about the patients' symptoms,the wound matches and the pterygium relapses among the 3 groups are carried out.Result In group A,28 eyes relapsed from the whole 72 eyes,and the rate of relapsing is 39%.In group B,28 eyes relapsed from the whole 59 eyes,and the rate of relapsing is 47.5%.In group C,39 eyes relapsed from the whole 45 eyes,with the rate of relapsing 86.6%.Conclusion Compared with the effect of the pure removal pterygium to treat recurrent pterygium, there exist lower rates of relapsing in corneal limbai stem cell autografting and the transplantation of fresh amnion.Corneal limbal stem cell auto-grafting is more effective than the transplantation of flesh amnion in lowering the rate of relapsing recurrent pterygium.In addition, corneal iimbal stem cells are easily to be found and economical,and it is the effective option in treating recurrent pterygium.