两种不同翼状胬肉手术方式对角膜屈光的影响

目的：探讨两种不同手术方式治疗原发性翼状胬肉前后视力及眼屈光度的情况。

方法：将翼状胬肉患者120例120眼随机分为A和B组，每组各60眼。A组采用翼状胬肉切除加自体角膜缘干细胞移植术； B组采用翼状胬肉切除加羊膜移植术。术后1wk内每天在裂隙灯显微镜下观察结膜和角膜创缘的愈合情况、移植片的生长情况、有无感染、角膜上皮修复情况及角膜新生血管生长情况等。术前2wk及术后3wk均进行裸眼视力、角膜曲率、角膜散光的检测。

结果：两组术后3wk的裸眼视力、角膜曲率和角膜散光与术前2wk比较，差异具有统计学意义(P<0.05)； 而两组之间比较，术后3wk的差异无统计学意义(P>0.05)。

结论：两种翼状胬肉手术方式均可使角膜屈光改变，提高术眼视力，降低散光。应根据患者自身情况决定手术方式。

Effect of corneal refractive after two surgical methods for treatment of primary pterygium

AIM: To investigate the performance of visual acuity and refractive after the two different surgical methods for treatment of primary pterygium.

METHODS: A total of 120 cases 120 eyes underwent pterygium surgery were divided into 2 groups randomly, group A(pterygium excision with limbal stem cell transplantation)and group B(pterygium excision with amniotic membrane transplantation). The incision condition of the wound margin of conjunctiva and corneal were observed everyday by slit lamp microscope on the first week after pterygium surgery, and the growth of transplantation, with or without infection and corneal epithelium repair and corneal growth of new blood vessels also were observed everyday by slit lamp microscope on the first week after pterygium surgery. Naked visual acuity, corneal curvature and corneal astigmatism were measured and compared in preoperative 2 weeks, postoperative 3 weeks.

RESULTS: In group A and B, the results of naked visual acuity, corneal curvature and corneal astigmatism in postoperative 3 weeks were different to that of preoperative with statistical significance(P<0.05). While the changes in postoperative 3 weeks had no statistical significance difference between two groups(P >0.05).

CONCLUSION: The surgery for pterygium can change the corneal refraction. Both pterygium excision with limbal stem cell transplantation and pterygium excision with amniotic membrane transplantation can decrease astigmatism degree and improve visual acuity. We should choose the operation method according to the patient's condition.