自体角膜缘干细胞移植治疗初发与复发翼状胬肉：泪膜恢复的比较

背景：以往的研究大都集中在各种不同手术方法对术后泪膜恢复的影响,未涉及同一手术方法对不同患者人群泪膜恢复的影响。目的：观察初发翼状胬肉和复发翼状胬肉患者行翼状胬肉切除联合自体角膜缘干细胞移植后的泪膜恢复情况。方法：选取初发翼状胬肉患者32例38眼,复发翼状胬肉患者28例35眼,分别行翼状胬肉切除联合自体角膜缘干细胞移植。移植前及移植后1周、1个月时进行两组患者的干眼症状评分,收集基础泪液分泌量,测量泪膜破裂时间。结果与结论：两组患者移植后1周均出现干眼症状和泪膜破裂时间缩短,复发组患者的干眼症状较初发组患者严重、泪膜破裂时间较初发组患者明显缩短,差异有显著性意义（P〈0.05）。两组患者的泪液分泌差异无显著性意义。移植后1个月初发组患者的干眼症状和泪膜破裂时间基本恢复正常,复发组患者的干眼症状较初发组患者严重、泪膜破裂时间较初发组患者明显缩短、泪液分泌较初发组患者明显减少,差异有显著性意义（P〈0.05）。结果提示复发性翼状胬肉患者移植后的泪膜稳定性及泪液分泌均较初发翼状胬肉患者恢复差,可以部分解释复发翼状胬肉患者移植后的复发率更高。

Lacrimal film recovery following autologous corneal limbus stem cells transplantation for treatment of primary and recurrent pterygium

BACKGROUND：Previous studies mainly focus on influence of different surgical methods on postoperative lacrimal film recovery.OBJECTIVE：To investigate the effect of one surgery,pterygium excision and autologous corneal limbus stem cells transplantation,on lacrimal film recovery between primary and recurrent pterygium.METHODS：A total of 32 cases（38 eyes） of primary pterygium and 28 cases（35 eyes） of recurrent pterygium were selected and all underwent pterygium excision and autologous corneal limbus stem cells transplantation.Questionnaire on dry eye,Schirmer I test and break-up time were performed before,one week and one month after operation.RESULTS AND CONCLUSION：One week after operation,both groups appeared dryness and shortened break-up time,which was more serious in recurrent pterygium group（P〈0.05）;there was no significant difference in Schirmer I test between two groups.One month after operation only recurrent pterygium group appeared dryness and shortened break-up time compared with primary pterygium group,which was nearly recovered（P〈0.05）.Results showed that the recovery of tear stability and lacrimal secretion was poorer in recurrent pterygium than in primary pterygium,which partly explains high recurrence rate of recurrent pterygium.