翼状胬肉切除联合角膜缘—结膜瓣移植的疗效观察

Effect observation of pterygium excision with limbal-conjunctival flap surgery

目的观察翼状胬肉切除联合角膜缘—结膜瓣移植术的临床疗效。方法翼状胬肉患者29例(31眼),所有患者均采用翼状胬肉切除联合角膜缘—结膜瓣移植术,术后观察患者角膜上皮愈合时间,视力恢复程度,追踪胬肉复发情况并分析并发症情况。结果 29例患者于术后3～4d角膜上皮修复27例29眼,至术后20d角膜上皮修复2例2眼。出现瓣下出血3例3眼。所有患者术后10～14d结膜瓣水肿消退,术后10d瓣下出血吸收,术后15d球结膜充血逐渐消退。翼状胬肉复发2例2眼,复发率为6.5%,其余27例29眼于1个月后结膜瓣愈合平整,植片边界分辨不清,随访3年无变化,胬肉治愈。术后3个月患者视力为(0.61±0.17)高于术前的(0.34±0.14),差异有统计学意义(P<0.05)。结论翼状胬肉切除联合角膜缘—结膜瓣移植是治疗翼状胬肉,减少复发的一种较为理想的方法,值得临床推广应用。

Objective To observe the curative effect of pterygium excision with limbal-conjunctival flap surgery. Methods 29 cases （30 eyes） patiemts with pterygium, all patients were given pterygium excision with limbal-conjunctival flap surgery, after treatment, observed the corneal epithelial healing time, visual acuity level, tracked pterygium recurrence and analyzed complications. Results Among 29 cases patients in the postoperative 3 - 4d corneal epithelial repair 27 cases （29 eyes ） ,20d after corneal epithelial repair 2 cases （2 eyes）. Appeared lobe hemorrhage 3 cases （3 eyes）. All patients with con- junctival flap edema after treatment for 10 - 14d, lobe hemorrhage absorption after treatment for 10d, conjunctival hyperemia subsided gradually after treatment for 15d. Pterygium recurrenced 2 cases （2 eyes） ,the recurrence rate was 6.5% ,the remai-ning 27 cases （29 eyes） conjunctival flap healing formation after treatment for 1 month, graft boundary confusion, followed three years of no change, pterygium cured. After treatment for 3 months, the visual acuity （0.61 ± 0.17） was higher than before treatment （0.34 ± 0.14）, the difference was statistically significant （ P 〈 0.05 ）. Conclusion Pterygium excision with limbal-conjunctival flap transplantation is an ideal method for the treatment of pterygium, reducing the recurrence, and worthy of clini-cal application.