三种手术方法预防翼状胬肉复发疗效分析

目的　探讨预防翼状胬肉复发的手术方法。方法　将 115眼翼状胬肉随机分为三组 ,分别予不同手术方法治疗。A组 3 5眼行翼状胬肉切除巩膜暴露 +丝裂霉素C(MitomycinC ,以下简称MMC)棉片敷贴 ;B组 3 7眼行翼状胬肉切除 +角膜缘干细胞移植 ;C组 43眼予翼状胬肉切除 +角膜缘干细胞移植 +MMC。观察三组复发率 ,角膜上皮愈合时间及并发症发生情况。结果　随访 1～ 3年半 ,A组复发率 2 5 .71%,B组复发率 13 .5 1%,C组复发率为 0 ,C组显著低于A、B组 (P<0 .0 5 )。A组角膜上皮愈合天数为 6± 1.17d ,B组为 5± 0 .96d ,C组为 4± 0 .64d ,C组愈合时间显著快于A、B组 (P <0 .0 1)。A组 2例浅层巩膜融解 ,C组 1例浅层角膜融解 ,均在 1周内治愈 ,未见其他严重并发症。结论　翼状胬肉切除 +角膜缘干细胞移植 +MMC治疗翼状胬肉疗效确切 ,并发症少 ,复发率低 ,值得临床推广。

Analysis of efficacy of different operations for preventing recrudescence of pteryium

Objective To evaluate the operations for preventing recrudescence of pterygium. Methods 115 eyes with pterygium were divided into 3 groups randomly. Pterygium was ablated by MMC, and sclera was exposed in group A (35 cases).Pterygium was ablated and limbal stem cells auto-graft transplantation was performed in group B (37 cases). Pteryium was ablated by MMC and limbal stem cells auto-graft transplantation was performed in group C (43 cases).Results The followed-up periods of post-operation ranged from12 to 42 months. The recrudescence rate was 25.71%, 8.10% in group A and group B, respectively. No recrudescence occurred in group C. Eyes'shallow sclera of 2 cases were smelted in group A and 1 eye's shallow cornea smelted on group C. All patients were cured within 1 week, and no other serious complications happened. Conclusion Technique of pterygium ablated by MMC and performed Limbal stem cells auto-graft transplantation was effective, which had less complications and lower recrudescence. So it is worth to generalize in clinical treatment.