角膜缘干细胞移植术与结膜移植术治疗外伤后假性胬肉及复发性胬肉疗效的比较

Comparison of transplantation of corneal limbal stem cell with conjunctival transplantation for the treatment of pseudopterygium and recurrent pterygium

目的 角膜缘干细胞移植术与结膜移植术治疗眼外伤后的假性胬肉及复发性胬肉的疗效比较,寻找低复发率的治疗方法。方法 40例(47眼)眼外伤后的假性胬肉及复发性胬肉,分别进行胬肉切除加自体(或异体)结膜移植或角膜缘干细胞移植术,术后观察两组的泪膜破裂时间(BUT)、角膜上皮修复时间及复发率。结果 角膜缘干细胞移植术的复发率为(11.11％),明显低于结膜移植术(30.00％),BUT恢复快,两组间比较差异有显著性(P<0.05);但比较角膜上皮修复时间其差异无显著性(P>0.05)。结论 对眼外伤后的假性胬肉及复发性胬肉,角膜缘干细胞移植术后BUT恢复快,且复发率低且疗效优于结膜移植。

Objectives To compare the effectiveness of the transplantation of corneal limbal stem cells with conjunctival transplantation for the treatment of pseudopterygium and recurrent pterygium. To evaluate the advantage of stem cell transplantation. Methods Forty cases (47 eyes) were divided into two groups at random. Twenty eyes underwent pterygium resection and conjunctival transplantation: of which 14 eyes were of recurrent, 6 eyes were pseudopterygium after chemical burn. Twenty-seven eyes were treated by pterygium resection and corneal stem cell transplantation: 17 eyes were of recurrent; 10 eyes, were of pseudopterygium caused by chemical burn. The graft being taken and epithelialization were observed by cornea fluorescent staining. The broken-up time (BUT) was measured. Results The recurrent rate in the group of limbal stem cell was 11. 11%, the recurrent rate in the group of conjunctival transplantation was 30. 00%. There were significant statistics differences of BUT and recurrent rate between the two groups. However, there was no statistical difference in the rate of the graft taken and epithelialization. Conclusions Transplantation of corneal limbal stem cell has an advantage over conjunctival transplantation in the treatment of pseudopterygium and recurrent pterygium.