角膜缘干细胞移植术治疗双侧翼状胬肉的疗效

目的：观察自体角膜缘干细胞移植术(LCAT)治疗双侧翼状胬肉的临床效果。

方法：前瞻性病例研究。收集2014-01/2015-07在解放军第四七四医院诊断为双侧翼状胬肉患者46例54眼，其中双眼双侧胬肉8例16眼，一眼双侧胬肉一眼鼻侧胬肉11例11眼(仅纳入双侧胬肉眼作为研究对象)，单眼双侧胬肉27例27眼，均采用鼻侧翼状胬肉切除联合同眼上方LCAT，而颞侧翼状胬肉切除联合对侧眼下方LCAT。术后1、7d，1mo，1a复查，复查时完成视力、裂隙灯等检查，观察术后并发症及翼状胬肉复发情况。

结果：完成1a随访患者共44例52眼，失访2例2眼。术后1a复发3例3眼(6%)，鼻侧翼状胬肉复发2眼，颞侧翼状胬肉复发1眼。未见其它术后并发症。

结论：鼻侧翼状胬肉切除联合同眼上方LCAT，同时颞侧翼状胬肉切除联合对侧眼下方LCAT治疗双侧翼状胬肉安全有效，复发率低。

Clinical efficacy of limbal-conjunctival autograft transplant for double-head pterygium

AIM: To observe the clinical efficacy of limbal-conjunctival autograft transplant(LCAT)for double-head pterygium.

METHODS: Prospective case study. Totally 46 patients(54 eyes)diagnosed with double-head pterygium collected in PLA 474 Hospital from January 2014 to July 2015, including 8 patients(16 eyes)with binocular double-head pterygium, 11 patients(11 eyes)with monocular double-head pterygium and the other eye with nasal side pterygium, pterygiun eyes only included as study subject, and 27 patients(27 eyes)with monocular double-head pterygium. The eyes with double-head pterygium underwent pterygium resection and autologous corneal limbal stem cell transplantation, nasal conjunctival flap was gotten from the superior bulbar conjunctiva of affected eye, and temporal conjunctival flap was gotten from the inferior bulbar conjunctiva of other eye. Follow-up the patients on 1d, 7d, 1mo and 1a after operation to complete the vision and slit lamps to observe the complications and pterygium recurrence.

RESULTS: Forty-four patients(52 eyes)completed the follow-up of 1a, while 2 patients(2 eyes)were lost. Three patients(3 eyes)developed recurrence, and the recurrence rate was 6%. Two eyes with nasal side pterygium developed recurrence and 1 eye with temporal side pterygium developed recurrence, while there was no complication observed.

CONCLUSION: Nasal conjunctival flap was gotten from the superior bulbar conjunctiva of affected eye, and temporal conjunctival flap was gotten from the inferior bulbar conjunctiva of other eye for double-head pterygium had good clinical effect and low recurrence rate, which provide a better way to treat double-head pterygium.