显微镜下自体角膜缘干细胞移植治疗翼状胬肉

Transplantation of Limbal with Conjunctival Flap Autograft to Treat Pterygum under Micoscop

目的为寻求治疗翼状胬肉更好的治疗方法,降低其手术后复发率。方法采用显微手术的方法及技术除净翼状胬肉,减少术中的组织损伤,降低术后反应,也基于对角膜缘干细胞的认识,采用带结膜瓣的角膜缘干细胞移植,对38例40眼翼状胬肉行显微手术切除,及带结膜瓣的角膜缘干细胞移植。结果38眼治愈,2眼复发。平均随访时间14个月,手术强调植片与创面的形态大小大致相同,才能使之平整,亦强调植片角巩缘侧与创面角巩缘侧对应,才能更好达到角膜缘干细胞的栅栏及分化为正常角膜上皮细胞,防止复发的目的。结论显微镜下行自体角膜缘干细胞移植治疗翼状胬肉的方法,具有手术切除胬肉较彻底、组织损伤小、术后反应轻、复发率较低的特点,有一定的实用价值。

Objective To observe an effective therapy and decrease the high rate of recurrence in the surgical treatment of pterygium. Methods Corneal limbal stem cell autograft and conjunctiva was performed in 38 patients （40 eyes） with primary pterygium. In all cases a free transplant of the superotemporal limbus with an adjacent piece of thin conjunctiva was placed in the excision area. Results Mean follow up was 14 months. Recurrence 0ccured in two eyes and others were cured. Conclusion Limbal stem cell autograft in micrurgy is an effective technique for pterygium treatment with a low rate of tissue damage, tissue reaction and recurrence.