角膜缘干细胞移植术治疗翼状胬肉的临床观察

Limbal stem cell transplantation in the treatment of pterygium: a retrospective analysis

目的探讨角膜缘干细胞移植术治疗翼状胬肉的临床效果。方法收集河南省平顶山市第二人民医院眼科2011年4月至2012年4月收治的98例(98只眼)翼状胬肉患者的临床资料。按照数字表法将患者分为观察组和对照组,每组各49例(49只眼)。观察组患者采用翼状胬肉切除联合角膜缘干细胞移植术进行治疗,对照组患者采用单纯翼状胬肉切除术进行治疗,采用卡方检验比较手术后两组患者翼状胬肉的复发率和并发症的发生情况。结果观察组和对照组患者的手术顺利,术中未出现不良反应或严重并发症。手术后观察组治愈率为95.92%(47/49),对照组患者治愈率为93.88%(46/49),两组比较,差异无统计学意义(χ2=0.211,P>0.05)。两组患者共98例(98只眼),回访98例(98只眼),有效回访率为100%。术后半年观察组患者翼状胬肉的复发率为6.12%(3/49),对照组为8.16%(4/49),两组患者复发率比较,差异无统计学意义(χ2=0.015,P>0.05);术后1年观察组复发率为12.24%(6/49),对照组复发率为14.29%(7/49),两组患者复发率比较,差异无统计学意义(χ2=0.013,P>0.05);术后2年观察组复发率为16.32%(8/49),对照组复发率为34.70%(17/49),两组患者复发率比较,差异有统计学意义(χ2=0.971,P<0.05)。结论采用角膜缘干细胞移植术治疗翼状胬肉的效果较好,复发率较翼状胬肉切除术更低。

Objective To evaluate the clinical potential of limbal stem cell transplantation in the treatment of recurrent pterygium.Methods Medical records of 98 patients with recurrent pterygium (98 eyes) who were seeking care in the Department of Ophthalmology, the Second People′s Hospital of Ping Dingshan City between April,2011 and April,2012 were obtained.Of these patients,49 were treated with limbal stem cell transplantation and the other 49 were left untreated as control subjects.The pterygium recurrence rate and complications after two-years of follow-up were analyzed.Results No complications were observed in the treatment stem cell group.The overall cure rate was 95.92%(47/49) in the treatment group and 93.88%(46/49) in the control group (χ2=0.211,P>0.05).The recurrence rate was 6.12%(3/49) in the treatment group and 8.16%(4/49) in the control group 6 months after treatment (χ2=0.015,P >0.05),12.24%(6/49) in the treatment group and 14.29% (7/49) in the control group 12 months after treatment (χ2=0.013,P >0.05),and 16.32%(8/49) in the treatment group and 34.70%(17/49) in the control group 2 years after treatment (χ2=0.971,P <0.05).Conclusion Against simple excision, limbal stem cell transplantation may potentially reduce the risk of recurrence as a novel therapy for recurrent pterygium.