术中应用丝裂霉素治疗不同类型原发性翼状胬肉的疗效观察

Efficacy of localized mitomycin C intraoperatively to treat patients with primary pterygium

目的:探讨丝裂霉素在不同类型原发性翼状胬肉术中局部应用的疗效。方法:选择翼状胬肉组织侵入角膜内>2mm的原发性翼状胬肉患者259例279眼,在显微镜下,按常规方法切除翼状胬肉的头颈体部,用0.2mg/mL的丝裂霉素溶液在巩膜上作用3min,生理盐水充分冲洗,缝合结膜,术后滴复方妥布霉素眼液,4次/d,涂复方妥布霉素眼膏,1次/晚,第7d拆线。随访12～18mo。结果:术后,271眼达到治愈标准,治愈率97.1%;8眼复发,复发率为2.9%。单眼单侧、双眼单侧、单眼双侧的复发率分别为1.8%,2.5%,14.3%。结论:术中局部应用丝裂霉素治疗原发性单眼单侧翼状胬肉效果良好,复发率明显降低,且未见明显副作用;而单眼双侧的翼状胬肉患者治疗后复发率仍较高。

AIM： To evaluate the therapeutic effect of localized mitomycin C（MMC） applied in operation for treating patients with pterygium. METHODS： Totally of 259 patients 279 eyes with pterygium by corneal incursion more than 2mm were received 0.2mg/mL MMC on sclerae for 3 minutes after pterygium resection under microscope. Subsequently, all eyes were treated with tobramycin and dexamethasone eyedrop （qid） and tobramycin and dexamethasone ointment （qn） for 1 week postoperatively. The corneal infiltration, blood vessels and plump degree of pterygium were observed. The follow-up of 12 to 18 months were carried out to all of patients. RESULTS： After operation, 271 eyes with pterygium were cured, which occupied 97.1%. Recrudescence was found in other 8 eyes with proportion of 2.9%, the patients suffered unilateral pteygium in one eye, unilateral pterygium in both eyes and bilateral pterygia in one eye were 18%,2.5%,14.3% respectively. CONCLUSION： Localized MMC intraoperatively is an effective treatment for primary pterygium when it only occurred in one eye with low recrudescence and without side-effect. However, the unilateral pterygium in both eyes or bilateral pterygia in one eye are still have high incidences to recur.