不同手术方式治疗翼状胬肉的临床疗效分析

目的：探讨不同手术方式治疗翼状胬肉的临床效果。

方法：对我院2006-01/2010-12行不同手术方式治疗的164例206眼翼状胬肉患者的临床资料进行回顾性分析。A组(36例50眼)采用单纯切除术； B组(41例47眼)采用单纯切除联合丝裂霉素术； C组(42例52眼)采用胬肉切除联合丝裂霉素和羊膜移植术； D组(45例57眼)采用胬肉切除联合自体角膜缘干细胞移植术。记录每例手术时间，术后1wk； 3，6，12，24mo进行随访观察，观察结膜愈合及胬肉复发情况等。

结果：A组复发率最高，B组复发率有所降低，C、D 组复发率较A组及B组明显降低，C、D 组复发率无明显差异。手术时间方面，单纯切除组的手术时间明显短于其他组，羊膜移植及自体角膜缘干细胞移植组的手术时间较长。复发主要发生在术后1a内。

结论：丝裂霉素可以降低单纯胬肉切除术的复发率，角膜缘干细胞移植及羊膜移植术可以更有效的降低胬肉的复发率。

Clinical effect analysis of different surgical excisions of primary pterygium

AIM: To compare the effect of primary pterygium excision using several surgeries.

METHODS: A total of 206 eyes of primary pterygium were selected and all underwent pterygium excision. They were divided into 4 groups. Group A with 50 eyes using simple pterygium excision. Group B with 47 eyes using simple pterygium excision and mitomycin C(MMC). Group C with 52 eyes using simple pterygium excision and amniotic membrane transplantation combined with MMC. Group D with 57 eyes using autologous corneal limbus stem cells transplantation. Postoperative follow-up was 2 years.

RESULTS: The recurrence rate was remarkably different between group A and the other three groups.The recurrence rate in group B was lower than that in group A, but higher than the other groups. The recurrence rates among the last two groups had no significant difference. Average surgery time was 13 minutes in the group A, which was greatly shorter than other groups. Average surgery time of the last two groups was a little longer. Most recurrences occurred within 12 months.

CONCLUSION: MMC can reduce the recurrence rate of simple pterygium excision. Pterygium surgeries including free autologous conjunctival grafting and amniotic membrane transplantation are associated with fewer recurrences.