翼状胬肉术后^(90)Sr β射线敷贴治疗疗效观察及复发相关因素分析(英文)

Postoperative ^(90)Sr β-irradiation for pterygium and the related factors for recurrence

目的:评估翼状胬肉切除术后90Srβ射线敷贴的疗效及安全性,分析翼状胬肉复发的相关因素。方法:2006-05/2008-09翼状胬肉患者79名93眼行切除术后90Srβ射线敷贴治疗。计算翼状胬肉复发率,同时比较男性与女性,年龄<40岁与≥40岁,原发性及复发性翼状胬肉在治疗后的复发率。结果:翼状胬肉复发7眼。<40岁及既往手术或其他治疗后复发性翼状胬肉患者复发率较高。翼状胬肉术后90Srβ射线敷贴治疗后并发症少见,包括轻微的结膜炎、术后疼痛、畏光、流泪等,但未发现严重的长期并发症,特别是无巩膜坏死及放射性白内障的发生。结论:翼状胬肉术后90Srβ射线敷贴治疗安全、有效,能降低翼状胬肉的复发率,且无严重并发症出现。年龄及复发性翼状胬肉可能影响治疗结果。

AIM： To investigate the efficacy and safety of postoperative 90Sr β-irradiation for patients with pterygium and analyze the recurrence-related factors.METHODS： Between May 2006 and September 2008, seventy-nine patients with 93 pterygium eyes were treated with surgery and postoperative 90Sr β-irradiation. After doing bare sclera technique of pterygium excision, postoperative 90Sr β-irradiation was carried out. A total dose of 2400 cGy dose was used in three fractions （800 cGy, each time, one week apart）. At the cut off time （three months）, the recurrence rate was calculated and compared between male and female, young （〈40 years） and old （≥40 years）, fresh and relapsing pterygium. RESULTS： Recurrence of the pterygium treated with surgery and postoperative 90Sr β-irradiation was observed in 7 of 93 （7.5%） cases. Recurrence-related factors analysis revealed that younger age （〈40 years）, relapse cases were risk factors for local recurrence. Complications noted were few： including moderate conjunctivitis, postoperative pain, photophobia and an increase in tear flow. However, no long-term serious side effects were observed in this study, such as scleral necrosis or radiation cataract.CONCLUSION： Bare sclera technique of pterygium excision followed by fractioned 90Sr β-irradiation is a safe and effective therapy to prevent a relapse and can be performed without serious side effects. The study also showed several factors might influence the therapy efficacy, such as age and previous surgical treatment.