翼状胬肉术中丝裂霉素C的应用

Intraoperative MMC in Preventing Recurrence of Pterygium

目的 丝裂霉素C能抑制翼状胬肉切除术后的复发，研究胬肉切除术中应用丝裂霉素C治疗翼状胬肉的有效性和安全性。方法将原发性翼状胬肉患者随机分为三组，术中应用0．02％丝裂霉素C组、术后用0．02％丝裂霉素C组和胬肉切除加角膜缘干细胞移植术组，观察术后复发率和并发症情况。结果 共有132例153只眼纳入本研究，其中术中用丝裂霉素C组50只眼中3只眼复发（6．0％），术后用丝裂霉素C组51只眼中4只眼复发（7．5％），胬肉切除加角膜缘干细胞移植术组52只眼中3只眼复发（5．8％）。三组间差别无统计学意义（P＞O．05）；随访期间三组患者均没有出现严重的并发症。结论翼状胬肉切除术中应用丝裂霉素C是治疗翼状胬肉简易有效地方法，且较术后应用丝裂霉素C可能更为安全。

Objective Aim This study was conducted to examine the efficacy and safety of intraoperatire MMC in preventing recurrence ofpterygium.Methods Prospective study on consecutive cases of primary pterygium randomized into three adjuvant groups： （ 1 ）intraoperative 0.02% MMC for 5 minutes; （2）postoperative 0.02% MMC for 5 days; （3）ptcrygium excision followed by corneal limbal stem cell autografting （CLSCA）.Patients were followed for recurrence and complications for a period of six months.Result 153 eyes of 132 patients who completed the study were randomized to receive intraoperative MMC （n=50）, postoperative MMC （n=51 ）or pterygium excision followed by CLSCA.There were 3 recurrences （6.0%）in the intraoperative group, 4 recurrences （7.5%）in the postoperative group and 3 recurrences （5.8%）in the pterygium excision followed by CLSCA group.There was no statistically significant difference in the recurrence rate among the three groups （P 〉0.05 ）.No significant complications were encountered in every group.Conclusion Simple excision combined with intraoperative MMC is effective and easy adjuvants for pterygium excision,but intra- operative MMC may be safer.Because of the possibility of serious late complications, controlled use of MMC and long term follow up are required.