翼状胬肉术后应用环孢素A和MMC的临床对比研究

目的:探讨翼状胬肉术后应用环孢素A和丝裂霉素C(MMC)的疗效和并发症方法:选取孝感市中心医院眼科2009-05/2011-05的翼状胬肉患者63例100眼,所有患者均行翼状胬肉切除术,术后随机分为两组。第一组术后用0.5g/L环孢素A滴眼液滴眼,4次/d,滴用12wk(环孢素A组);第二组术后用0.2g/L丝裂霉素C滴眼液滴眼,2次/d,滴用1wk(丝裂霉素C组)。随访6～24(平均18)mo,观察复发率。结果:至术后18mo,环孢素A组50眼有4眼(8%)复发,丝裂霉素C组50眼有3眼(6%)复发,经卡方检验,P>0.05。环孢素A组有3眼滴药当时有烧灼刺痛感、球结膜轻度充血等反应,停药后消失,术后畏光、流泪和疼痛症状较轻,结膜愈合时间为5～10d,所有眼均未见有角膜上皮损伤等不良并发症的发生。丝裂霉素C组术后畏光、流泪和疼痛症状较重,有12眼(24%)出现结膜伤口延迟愈合(10～14d)。结论:术后滴用环孢素A滴眼液或丝裂霉素C滴眼液防止翼状胬肉复发疗效近似,但术后滴用环孢素A滴眼液反应轻,副作用少。

Clinical comparison of CsA and MMC in postoperative application to pterygium

AIM: To investigate the curative effects and complications of CsA and mitomycin C(MMC)applied to postoperative pterygium.

METHODS: Totally 63 patients(100 eyes)who received treatment at Xiaogan Central Hospital from May 2009 to May 2011 were selected. All the patients underwent resection of pterygium and were divided into two groups randomly. Group 1 received eye drops of 0.5g/L CsA four times per day for 12 weeks(briefed as Group CsA, n=50), and Group 2 received eye drops of 0.2g/L MMC twice per day for 1 week(briefed as Group MMC, n=50).

RESULTS: Four eyes(8%)among 50 in Group CsA and 3 eyes(6%)in Group MMC relapsed after Chi-square test( P>0.05). In Group CsA, 3 patients revealed responses of burning pricking pain and slight congestion of bulbar conjunctiva that disappeared after drug withdrawal. Only slight postoperative photaesthesia, lachrymation and pain were observed and the conjunctiva healing required 5-10 days. No corneal epithelium damage was observed among all eyes. In MMC group, photaesthesia, lachrymation and pain were relevantly severe, and 12 eyes(24%)displayed delayed union in conjunctival wounds(10-14 days).

CONCLUSION: For postoperative applications of CsA and MMC to pterygium, they are equivalent in preventing recurrence of pterygium, yet postoperative drop of CsA revealed lighter reaction and fewer side effects.