乙醇松解翼状胬肉切除联合角膜缘上皮移植的疗效观察

Clinical observation of alcohol lysis combined with limbus corneae epithelial transplantation in the treatment of primary pterygium

目的初步观察乙醇松解在角膜缘上皮移植治疗翼状胬肉中的临床效果。方法随机分组对比研究。将176例（192只眼）初发翼状胬肉随机分A、B两组：A组（87例90只眼）单纯翼状胬肉切除联合角膜缘上皮移植；13组（B组89例102只眼）乙醇松解胬肉切除联合角膜缘上皮移植。对比观察两组角膜创面上皮愈合时间及复发率。结果A组角膜创面愈合时间平均（5．47±1．33）d；B组平均（3．69±1．38）d，两组差异有统计学意义（t=-9．0208；P〈0．01）。术后随访18～30个月，平均（22．5±5．6）个月，术后6月A、B组均无复发；A组术后6～12月复发3只眼；12～18月复发3只眼；18～24月后复发1只眼，复发率7．87％。B组术后6。18个月无复发，18～24月后复发2只眼，复发率1．96％，差异有统计学意义（U=8．802；P〈0．01）。结论乙醇松解胬肉切除联合角膜缘上皮移植从复发基础和原因两方面抑制胬肉复发，值的临床推广应用。

Objective To observe clinical effect of alcohol lysis combined with corneal limbus epithelial transplantation in the treatment of primary pterygium.Methods The prospective randomized paired-eye trial was studied.The 176 patients （192 eyes） with primary pterygium were allocated to two groups： excision of pterygium with corneal limbus epithelial transplantation surgery （Group A, 87 cases of 90 eyes） and alcohol lysis combined with corneal limbus epithelial transplantation （Group B, 89 cases of 102 eyes）.The average epithelial healing time of postoperative wound on cornea and recurrence rate between Group A and Group B were compared.Results The average epithelial healing time of postoperative was （5.47±1.33 ） days in Group A and （3.69± 1.38 ） days in group B.The difference between two groups was significant （t=9.0208, P〈 0.001 ）.Followed up periods of postoperative eyes ranged from 18-30 （22.5± 5.6） months, 7 of 90 eyes （7.87%） in Group A and 2 of 102 eyes （1.96%） in Group B were recurred.The difference was significant （U=8.802, P〈 0.01 ）.Conclusions Alcohol lysis combined with corneal limbus epithelial transplantation can reduce the recurrence from both basis and cause, and it is worth for clinical application.