翼状胬肉切除联合丝裂霉素C术后巩膜溶解的分析

目的:探讨翼状胬肉切除联合使用丝裂霉素C(mitomycin C,MMC)术后巩膜溶解的发生机制及预防、治疗。方法:对2005/2009年我院收治的7例翼状胬肉切除联合MMC术后巩膜溶解患者进行相关检查,并通过局部药物或手术方法进行治疗。结果:患者7例均无全身免疫性疾病病史,且全身检查亦未发现免疫性疾病的表现。所有患者病变位于原翼状胬肉切除部位,且局部表现为组织缺血,变薄,部分患者病变区域可透见深层色素组织,甚至形成巩膜葡萄肿。通过局部药物或手术治疗,病情得到控制,且在随访期间无复发。结论:翼状胬肉切除手术为降低复发率,可采用联合MMC治疗,但是在MMC的浓度及作用时间上应慎重选择,并且术中应尽量减少局部组织的烧灼,以保证局部的血液供应,预防巩膜溶解的发生。

Analysis on scleral melting after pterygium excision with mitomycin C

AIM:To discuss the mechanism,prevention and therapy of the scleral melting after pterygium excision with intraoperative application of mitomycin C(MMC).·METHODS:Seven patients with scleral melting after pterygium excision with MMC were examined and treated with topical drugs or surgery.·RESULTS:Neither history nor positive manifestation of immunological diseases were found by physical examination.But the ischemic,attenuating could be found at the tissue where the pterygium was excised,and the pigment tissue appeared in some patients,even the staphyloma had formed.The topical drugs and surgery were adopted according to the severity of melting.No recurrences were found during the follow-up.·CONCLUSION:To reduce the recurrences after the excision,the assistant treatment can be adopted.But the concentration and the duration of application should be considered,and the overdose of cauterization should be avoided to assure the enough blood supply at the wound.