角膜缘干细胞联合羊膜移植治疗翼状胬肉疗效观察

Observation of limbal stem cell and amniotic membrane transplantation for treatment of pterygium

目的:观察自体角膜缘干细胞移植与羊膜移植术治疗翼状胬肉的临床疗效。方法:将126例142眼翼状胬肉患者随机分成A,B组,A组64例72眼行翼状胬肉切除联合角膜缘干细胞移植术;B组62例70眼行翼状胬肉切除联合羊膜移植术,术后1wk;1mo及3mo,观察比较移植片生长、角膜创面修复、角膜新生血管及胬肉复发率。术后随访24mo。结果:A、B两组角结膜上皮愈合时间分别为(2.6±0.4)d和(3.2±0.7)d,两组比较差异有显著性差异(P<0.05);A组2例2眼翼状胬肉复发,治愈率为97.1%,复发率2.9%;B组9例12眼翼状胬肉复发,治愈率为81.8%,复发率18.2%;两组比较差异有统计学意义(P=0.003)。结论:自体角膜缘干细胞移植与羊膜移植术均可有效防止翼状胬肉的复发,具有方便、创伤小,修复快,术后患者自觉症状轻,复发率低等优点。

AIM：To observe the limbal stem cell transplantation and amniotic membrane transplantation for treatment of pterygium. METHODS： A total of 126 cases （142 eyes） with wing- shaped pterygium were randomly divided into A, B group, A group of 64 cases （72 eyes） underwent pterygium excision combined with limbal stem cell transplantation; B group of 62 cases （70 eyes） underwent pterygium excision with amniotic membrane transplantation. 1 week, 1 month, and 3 months after operation, the growth of grafts, corneal wound healing, corneal new blood tube and pterygium recurrence rate were observed and compared. Postoperative follow-up of 24 months, was conducted. RESULTS：A and B groups conjunctiva epithelial healing time was （2.6± 0.4） day and （3.2 ± 0.7） day, the difference was significant （ P 〈 0.05） ; A group had 2 cases （2 eyes） with pterygium recurrence, the cure rate was 97.1%, the recurrence rate of 2.9%; B group had 9 cases （12 eyes） with pterygium recurrence, the cure rate was 81.8%, the recurrence rate of 18.2% ; difference between the two groups was statistically significant （P= 0. 003）. CONCLUSION：Self limbal stem cell transplantation and amniotic membrane transplantation can be effective in preventing the recurrence of pterygium, with advantages of less trauma, fast repair, mild postoperative symptoms and low recurrence rate.