翼状胬肉切除联合自体角膜缘干细胞移植术前后角膜屈光状态的变化

Changes of corneal curvature before and after pterygium excision combined with autoallergic limbus corneal stem cells transplantation

目的探讨翼状胬肉切除联合自体角膜缘干细胞移植手术前后患者角膜屈光状态的变化。方法选取行翼状胬肉切除联合自体角膜缘干细胞移植手术的患者56例(72眼),于术前及术后1个月、3个月分别验光并测量角膜水平和垂直方向的角膜曲率和屈光状态。结果术前顺规散光52眼(占72.2%),术后1个月顺规散光39眼(占54.2%),术后3个月顺规散光40眼(占55.6%)。术前柱镜度数平均为(2.19±1.36)D,术后1个月平均为(1.25±0.96)D,术后3个月平均为(1.23±1.07)D;术后1个月、3个月与术前相比,差异均有显著统计学意义(P均<0.001);术后1个月与术后3个月散光度数相比,差异无统计学意义(t=0.677,P>0.05)。手术前后角膜垂直方向与水平方向角膜屈光力差值△K的比较(排除6眼因胬肉过大而无法测出角膜曲率者):术前平均为(4.11±3.25)D,术后1个月平均为(0.39±0.28)D,术后3个月平均为(0.36±0.30)D;术后1个月及术后3个月与术前相比,差异均有显著统计学意义(P均<0.001),术后1个月与术后3个月△K相比,差异无统计学意义(t=0.669,P>0.05)。结论翼状胬肉切除联合自体角膜缘干细胞移植术能明显减轻角膜散光度数,提高患者视觉质量,是目前治疗翼状胬肉切实有效的方法。

Objective To investigate the changes of corneal curvature before and after pterygium excision combined with autoallergic limbus corneal stem cells transplantation. Methods This study was conducted on 72 eyes of 55 patients, who were treated with pterygium excision combined with autoallergic limbus corneal stem cells transplantation. The optometry was taken, and curvatures of corneal horizontal or vertical direction were measured before surgery and at 1 month,3 months after surgery,respectively. Results Astigmatism with rule was 52 eyes （72.2%） before surgery, 39 eyes （ 54.2% ） at 1 month after surgery, and 40 eyes （55.5%） at 3 months after surgery. The mean value of cylindrical mirror was （2.19 ± 1.35） D before surgery, （ 1.25 ±0. 95） D at 1 month after surgery, and （ 1.23 ±1.07 ） D at 3 months after surgery. There were significant differences for that at 1 month or 3 months after surgery compared with that before surgery（ both P 〈 0. 001 ）, however, no significant difference was found between that at 1 month and 3 months after surgery（ t = 0.577 ,P 〉 0.05 ）. The difference between vertical direction and horizontal direction in keratometry（△K） was （4.11 ±3.25 ）D before surgery, （0. 39 ±0.28 ） D at 1 month after surgery, and （ 0.36 ±0.30 ） D at 3 months after surgery. There were significant differences for △K at 1 month or 3 months after surgery compared with △K before surgery （ both P 〈 0.001 ）, but no significant difference was found between △K at 1 month and 3 months after surgery（ t = 0. 559 ,P 〉 0. 05 ）. Conclusion Pterygium excision combined with autoallergic limbus corneal stem cells transplantation is an effective way for pterygium with reducing corneal astigmatism and improving visual quality.