复发性翼状胬肉两种术式术后干眼症的观察

TWO SURGICAL PROCEDURES FOR RECURRENT PTERYGIUM:AN OBSERVATION OF POSTOPERATIVE XEROPHTHALMIA

目的探讨两种术式对复发性翼状胬肉术后泪膜功能的影响。方法将50例复发性翼状胬肉病人随机分为2组,A组行胬肉切除联合自体角膜缘干细胞移植术,B组行胬肉切除联合丝裂霉素C应用。分别于术前及术后1个月行干眼主观症状评价问卷调查、基础泪液分泌试验及泪膜破裂时间检查。结果术前两组干眼症状评分、基础泪液分泌及泪膜破裂时间差异无统计学意义(P>0.05);术后1个月A组干眼症状评分明显低于B组,基础泪液分泌及泪膜破裂时间明显高于B组(t=2.03～7.06,P<0.05)。结论与胬肉切除联合丝裂霉素C应用比较,胬肉切除联合自体角膜缘干细胞移植可减少复发性翼状胬肉术后干眼症的发生。

Objective To assess the influence of two operative procedures on lacrimal film for recurrent pterygium （RP）. Methods A total of 50 eyes with RP were randomly divided into two groups： group A and group B. Patients in A group were trea- ted with combined pterygium excision and autologous corneal limbus stem cells transplantation, those in B group were treated with combined pterygium excision and application of rnitomycin C. A questionnaire survey on dry eye, Schirmer test and break up time were performed before and one month after operation. Results Before surgery, the differences between the two groups were not significant in regard to dry-eye-symptoms score, basic Schirmer test, and break-up time of tear film; One month after surgery, the dry-eye-symptoms score in group A was lower than that in group B, and the scores of basic Schirmer test, and break-up time of tear film were higher than group B （t =2.03--7.06,P〈0.05）. Conclusion Combined pterygium excision and autologous corneal lirnbus stem cells transplantation can reduce the occurrence of dry eyes in recurrent pterygium.