巨大翼状胬肉切除自体健眼角膜缘干细胞移植术后泪膜功能的变化

Corneal Tear Film Function Changes After Pterygium Excision with Autologous Stem Cell Transplantation

目的探讨自体健眼角膜缘干细胞移植治疗巨大翼状胬肉术后泪膜功能的变化。方法接受自体健眼角膜缘干细胞移植治疗巨大翼状胬肉患者31例31眼,通过全面检查,排除糖尿病、甲状腺功能亢进、类风湿性关节炎、睑板腺功能障碍等,影响泪膜功能的疾病,记录术前及术后30 d、60 d、90 d基础泪液分泌实验(SIt)、泪膜破裂时间(BUT)、角膜荧光素染色(FL)的结果。术前患眼与健眼对照,术后不同时间结果与术前对照。结果术前患眼与健眼比较:患眼的SIt明显减少,BUT明显缩短,FL评分明显高于健眼,差异具有统计学意义(P<0.01)。患眼手术前后比较:术后30 d,3项检测结果与术前无统计学意义(P>0.05);术后60 d,SIt比术前增加(P<0.01),BUT明显延长(P<0.01),FL评分比术前显著降低(P<0.01),与健眼相比,SIt接近健康水平(P>0.05),BUT及FL评分仍有差异(P<0.01);术后90 d,3项检测结果已恢复至健眼水平(P>0.05)。结论巨大翼状胬肉切除自体健眼角膜缘干细胞移植术,可使患眼泪膜功能得到很大程度的改善。

Objective To investigate the changes in tear film function after pterygium excision with autologous stem cell transplantation.Methods 31 patients（31 eyes） with large pterygium were performed healthy corneal autologous stem cell transplantation.The patients through a comprehensive examination,exclude diabetes,hyperthyroidism,rheumatoid arthritis,meibomian gland dysfunction,tear film function and other effects disease.Basal tear secretion test（SIt）,tear film breakup time（BUT） and corneal fluorescein staining（FL） were recorded in preoperative,30 d,60 d,90 d and postoperative.Results The preoperative comparison between ill eye and health eye： The SIt reduced significantly in ill eye,BUT was significantly shorter,FL score was significantly higher than the healthy eye,the difference was statistically significant（P0.01）.Before and after ocular surgery： after 30 d： three test results with no significant preoperative（P0.05）;after 60 d： SIt increased than the preoperative（P0.01）,BUT significantly prolonged（P0.01）,FL score significantly lower than preoperative（P0.01）.compared with the healthy eye,SIt close to the level of health（P0.05）,BUT and FL score are still differences（P0.01）;after 90 d,three test results has been restored to health the eye level（P0.05）.Conclusion Tear film function can be significantly improved by great of large pterygium excision with autologous healthy corneal stem cell transplantation.