翼状胬肉显微切除联合丝裂霉素C加自体带角膜缘上皮结膜移植术观察

Therapeutic effect observation on microsurgery application of limbal cornea stem cell autograft transplantation combined with MMC in pterygium patients

目的探讨翼状胬肉显微手术方法，观察翼状胬肉切除联合应用丝裂霉素C（MMC）加自体带角膜缘上皮的结膜移植术治疗翼状胬肉的疗效。方法对1251例1326只眼，在手术显微镜下剖切分离球结膜与病变组织，切除胬肉并做广泛的变性球筋膜切除，在结膜下放置0．2mg／ml的MMC棉片，彻底冲洗后将同侧眼颞上方带有角膜缘上皮的结膜瓣移植到胬肉处的巩膜上。术后随访12—72月，平均27．5月，观察复发情况。结果术后反应轻，移植片存活，37只眼复发，复发率为2．79％。结论翼状胬肉显微手术切除联合应用丝裂霉素c加自体带角膜缘上皮的结膜移植术，术后复发率低，是一种安全、有效的方法。

Objective To explore microsurgery methods of pterygium, to observe the clinical efficacy of conjunctiva with corneal limbal epithelial autograft transplantation combined with MMC in pterygium patients. Mefhods A total of 1251 cases （1326 eyes） of pterygium were treated by separating conjunctiva and pathological tissues under microscope, excising the pterygium combined with extensive excision of denatured bulbar conjunctiva. A 0.2mg/ml mitomycin C （MMC） cotton patch was placed under the bulbar conjunctiva for 2-3 minutes, after cleaned up thoroughly, the superior temperal limbal stem cells and their adjacent bulbar conjunctiva as graft transplantation were repaired the above wound. All cases were followed up for 12-72 months, with an average of 27.5 months. The recurrence of pterygium was observed after surgery. Results Response was light, graft survival, 37 recurrent eyes were foun. The recurrence rate was 2.79 percent. Conclusions It is effective and safe that microsurgery application of limbal cornea stem cell autograft transplantation combined with MMC in pterygium patients. It has good effect, easy operation and low recurrence.