不同手术方式治疗复发性翼状胬肉的疗效观察

目的比较两种不同手术方式治疗复发性翼状胬肉的临床疗效。方法将67例（75眼）复发性翼状胬肉患者随机分为A、B两组,A组31例（34眼）接受异体新鲜羊膜移植术联合术中应用丝裂霉素C,B组36例（41眼）接受自体角膜缘干细胞移植术联合术中应用丝裂霉素C,术后随访6～24个月（平均14.3个月）,观察植片生长情况、角膜上皮愈合时间及翼状胬肉再复发率,并对数据进行统计学分析。结果植片生长情况：所有病例植片生长良好,未发生排斥反应及植片溶解;角膜上皮愈合时间：A组平均愈合时间为5.88 d,B组平均愈合时间为5.63 d,两组的平均愈合时间差异无统计学意义（P〉0.05）;再复发率：A组为20.59%,B组为4.88%,两组再复发率差异有统计学意义（P〈0.05）。结论异体新鲜羊膜移植术联合术中应用丝裂霉素C和自体角膜缘干细胞移植术联合术中应用丝裂霉素C均能缩短复发性翼状胬肉术后角膜上皮愈合时间,减轻患者的自觉症状,而后者能显著降低术后再复发率,是安全有效的手术方法,值得临床推广应用。

Observation of the curative effects on different operation methods for recurrent pterygium

Objective To compare the curative effects of two different operation methods for recurrent pterygium.Methods 75 eyes of 67 patients with recurrent pterygium were randomly divided into two groups: 34 eyes of 31 patients in group A were accepted allogeneic transplantation of fresh amniotic membrance combined with mitomycin C,41 eyes of 36 patients in group B accepted autologous transplantation of corneal limbal stem cells combined with mitomycin C.Patients were followed up for 6-24 moths(averaged 14.3),growth of the graft,repair time of corneal epithelium and recurrence rate were observed.Results Growth of the graft: in all cases,the graft grew good,no rejection and graft dissolution happened;the repair time of corneal epithelium: the average repair time was 5.88 d in group A,5.63 d in group B,there was no significant difference between group A and group B(P > 0.05);the recurrence rate: the recurrence rate was 20.59% in group A,4.88% in group B,there was significant difference between group A and group B(P < 0.05).Conclusion Allogeneic transplantation of fresh amniotic membrance combined with mitomycin C and autologous transplantation of corneal limbal stem cells combined with mitomycin C can also lower the repair time of corneal epithelium and alleviate the patient’s symptoms,but the later can reduce the recurrence rate remarkably,it is a safe and effective surgical operation method of recurrent pterygium and is worth spreading.