翼状胬肉不同术式效果观察

Observation and analysis of efficacy in defferent pterygium surgery

目的寻求一种理想的手术方法以减少胬肉术后的复发率。方法对636例726眼采用单纯胬肉切除术(209眼),带蒂结膜瓣转移术(158眼),保存羊膜移植术(94眼),丝裂霉素C应用加带蒂结膜瓣转移术(131眼),自体角膜缘干细胞移植术(134眼)等方法治疗,随访6月至7年,比较其复发率。结果术后复发率,单纯胬肉切除为2967%,带蒂结膜瓣转移术为2025%,保存羊膜移植术为1596%,丝裂霉素C应用加带蒂结膜瓣转移术为611%,自体角膜缘干细胞移植术为373%。结论自体角膜缘干细胞移植术和丝裂霉素C应用加带蒂结膜瓣转移术减低了胬肉的复发率,取得了良好的效果,是二种理想的手术方法,值得推广。

Objective To explore an ideal method of surgery to reduce recurrence rate of pterygium surgery.Methods 636 patients(726 eyes)were divided into four random groups.The first group(209 eyes)was treated with pterygium excision>The second group(158 eyes)was treated with conjunctival flap transference.The third group(94 eyes)was treated with amminotic membrane transference.The fourth group(131 eyes)was treated with mitomycin-c and conjunctival flap transference.The fifth group(134 eyes)was treated with limbal stem cells autograft transplantation.All patients had been follow up for 6～84 months,then compared the recurrence rate.Results The first group recurrence rate was 29 67%,the secend group was 20 25%,the third group was 15 96%,the fourth grop was 6 11%,and the fifty group was 3 73%.Conclusions The pterygium recurrence rate was reduced with limbal stem cells autograft transplantation,mitomycin-c and conjunctival flap transference.The methods achieved good results,It is two ideal methods of pterygium surgery,is worth spreading.