两种翼状胬肉切除手术的同体异眼比较

Effects of two surgical techniques for excision of pterygium on different eyes of homobody

目的:在同体异眼上比较翼状胬肉切除联合角膜缘干细胞滑行移植术和经典的胬肉切除联合角膜缘干细胞移植术的效果。方法:选取105例210眼初发性翼状胬肉患者,左右眼分别行胬肉切除联合角膜缘干细胞滑行移植术(A术式)和经典的胬肉切除联合角膜缘干细胞移植术(B术式)。术后随访12mo,比较双眼术后不适症状的程度及持续时间、角膜上皮愈合时间以及翼状胬肉复发情况。结果:A术式8眼翼状胬肉复发,复发率为7.8%;B术式6眼复发,复发率为5.9%,两组差异无统计学意义(P>0.05);在术后1wk,有86.7%患者诉行B术式的眼不适症状重于行A术式的眼,术后1,2wk及1mo时,不适症状眼数A术式眼均<B术眼,差异有统计学意义(P<0.01);角膜上皮愈合时间A术式<B术式,差异有统计学意义(P<0.05)。结论:翼状胬肉切除联合角膜缘干细胞滑行移植术与经典的胬肉切除联合角膜缘干细胞移植术相比,术后胬肉复发率无明显差异,但具有简便快捷,创伤小,修复快,术后患者自觉症状轻等优点。

AIM： To compare the effects of excision of pterygium with gliding the corneal limbal stem cells beside pterygium-neck（A operation） and classical pterygium excision combined with corneal limbal stem cells trans-plantation（B operation） on different eyes of homobody. METHODS： There were 105 patients 210 eyes with initial pterygium in two eyes, one eye got A operation and the other got B operation. The postoperative follow-up period was 12 months. The duration of complaint symptoms, the time of corneal epithelium healing and recurrence of pterygium were observed after operation. RESULTS： Eight eyes of 105 eyes that got A operation were recurred, the rate of recurred was 7.8%. 6 eyes of 105 eyes that got B operation were recurred, the rate of recurred was 5.9%. The difference was not significantly different（P〉0.05）. 87.6% patients complained that the eyes got B operation were more uncomfortable.The duration of complaint symptoms after operation was significantly different between two operation（P〈0.01）. The time of corneal epithelium healing was also signifi-cantly different（P〈0.05）. CONCLUSION：The excision of pterygium with gliding the corneal limbal stem cells beside pterygium-neck is a convenient, micro-injury and light compliant symptoms surgery. The rate of recurred is not significantly different between this operation and classical pterygium excision combined with corneal limbal stem cells transplantation.