翼状胬肉切除自体角膜缘干细胞移植联合丝裂霉素C治疗翼状胬肉的效果

Effect of pterygium excision autologous limbal stem cell transplantation combined with mitomycin C in the treatment of pterygium

目的探讨翼状胬肉患者行胬肉切除术同时给予自体角膜缘干细胞移植与丝裂霉素C联合治疗的效果,为临床选取治疗方案提供参考。方法选取2017年1月—2019年2月于安徽省六安市中医院眼科就诊的翼状胬肉患者104例(135眼)为研究对象,根据简单数字随机分组法将其分成观察组52例(66眼)与对照组52例(69眼)。对照组采用翼状胬肉切除自体角膜缘干细胞移植治疗,观察组采用翼状胬肉切除自体角膜缘干细胞移植联合丝裂霉素C治疗,随访12个月。比较两组临床疗效、康复情况、角膜散光度、并发症及复发情况。结果观察组总有效率明显高于对照组,差异有统计学意义(P<0.05)。术后两组角膜上皮修复时间、眼部刺激症消失时间及移植片愈合时间比较,差异无统计学意义(P>0.05)。两组术后3个月角膜散光度均较术前明显下降,且观察组显著低于对照组,差异均有统计学意义(均P<0.05)。两组术后3个月内并发症率比较,差异无统计学意义(P>0.05)。观察组总复发率明显低于对照组,差异有统计学意义(P<0.05)。结论翼状胬肉患者行胬肉切除术同时给予自体角膜缘干细胞移植与丝裂霉素C联合治疗的治愈率高,角膜散光度改善效果好,术后复发率低,推广应用价值高。

Objective To investigate the effect of pterygium excision combined with autologous limbal stem cell transplantation and mitomycin C in the treatment of patients with pterygium,and to provide a reference for clinical treatment selection.Methods A total of 104 pterygium patients(135 eyes)admitted to the Department of Ophthalmology,Traditional Chinese Medicine Hospital of Lu′an from January 2017 to February 2019 were selected as study subjects.According to the simple number random grouping method,they were divided into the observation group with 52 cases(66 eyes)and the control group with 52 cases(69 eyes).The control group was treated with pterygium excision autologous limbal stem cell transplantation,while the observation group was treated with pterygium excision autologous limbal stem cell transplantation combined with mitomycin C,follow-up for 12 months.Clinical efficacy,rehabilitation,corneal astigmatism,complications and recurrence were compared between the two groups.Results The total effective rate of the observation group was significantly higher than that of the control group,with statistically significant difference(P<0.05).There was no significant difference in the repair time of corneal epithelium,the disappearance time of ocular irritation and the healing time of grafts between the two groups after surgery(P>0.05).Three months after surgery,the corneal astigmatism of both groups was significantly decreased compared with that before surgery,and the observation group was significantly lower than the control group,with statistically significant differences(all P<0.05).There was no significant difference between the two groups in the complication rate within 3 months after surgery(P>0.05).The total recurrence rate in the observation group was significantly lower than that in the control group,with statistically significant difference(P<0.05).Conclusion The curative rate of pterygium excision combined with autologous limbal stem cell transplantation and mitomycin C in patients with pterygium is high,the improvement of corneal astigmatism is good,the postoperative recurrence rate is low,and the application value is high.