自体角膜缘干细胞移植联合双层生物羊膜移植治疗翼状胬肉

目的：观察自体角膜缘干细胞移植联合双层生物羊膜移植治疗翼状胬肉的有效性和安全性。

方法：2010-06/2013-12我院手术的翼状胬肉患者，根据翼状胬肉分型分级不同，采取不同的手术方法，A组应用自体角膜缘干细胞移植术，B组应用自体角膜缘干细胞移植联合双层生物羊膜移植术，术后随访6～36mo，观察术后复发率。

结果：共有149例155眼纳入本研究。其中A组75眼应用自体角膜缘干细胞移植术：单薄型2级10眼中1眼复发，3级14眼中2眼复发； 肥厚型17眼中2眼复发； 复发型21眼中3眼复发。痊愈68眼，复发8眼，总复发率10.67%。B组80眼应用自体角膜缘干细胞移植联合双层生物羊膜移植，单薄型3级及4级以上无复发； 肥厚型21眼中1眼复发； 复发型37眼中2眼复发。痊愈77眼，复发3眼，总复发率3.75%。两组在肥厚型和复发型降低复发率方面有显著统计学意义(P<0.05)。

结论：提示不同类型的胬肉采取不同的手术方式其手术复发率不同。自体角膜缘干细胞移植术适合于无根型、单薄型2级以下的翼状胬肉； 自体角膜缘干细胞移植联合双层生物羊膜移植适合于单薄型2级以上、肥厚型、复发型的翼状胬肉手术治疗，复发率低，是一种理想的手术方法。

Auto-corneal limbus stem cell transplantation combined with double biological amniotic membrane transplantation in the treatment of pterygium

AIM: To observe the effectiveness and safety of auto-corneallimbus stem cell transplantation combined double biological amniotic membrane transplantation in the treatment of pterygium

METHODS: The patients performed pterygium surgeries in our hospital between 2010-06 and 2013-12 were selected, according to different pterygium classification grading, different surgical methods were taken. Group A: autologous corneal limbus stem cell transplantation was conducted. Group B: autologous corneal limbus stem cell transplantation combined double biological amniotic membrane transplantation were conducted. The patients were followed up 6-36mo after operation, the postoperative recurrence rate was observed.

RESULTS: A total of 149 cases with 155 eyes included in this study, including 75 eyes in group A with the application of autologous limbal stem cell transplantation: thin type grade 2, 10 eyes(1 eye recurred), grade 3, 14 eyes(2 eyes recurred); Hypertrophic 17 eyes(2 eyes recurred); Recurrence type 21 eyes(3 eyes recurred); Recovered 68 eyes(8 eyes recurred, the total recurrence rate was 10.67%); Group B: 80 eyes treated with autologous limbal stem cell transplantation combined double biological amniotic membrane transplantation, thin type above grade 3 and grade 4(no recurrence); Hypertrophic 21 eyes(1 eye recurred); Recurrence type 37 eyes(2 eyes recurred); Recovered 77 eyes(3 eyes recurred, the recurrence rate was 3.75%). Two groups of hypertrophic type, recurrence is significant in reducing the recurrence rate(P<0.05).

CONCLUSION: It indicates that recurrence rates are different when adopting different ways of operations.Autologous corneal limbus stem cell transplantation is applicable for no root type, pterygium of thin type below grade 2; Autologous corneal limbus stem cell transplantation with double biological amniotic membrane transplantation is suitable for thin type above grade 2, hypertrophic type, recurrent type of pterygium, with low recurrence rate, so it is the ideal surgical method.