6例翼状胬肉切除术后并发角巩膜病变的回顾性分析

Retrospective analysis of the complications of the cornea or sclera after pteryguim excision

目的探讨翼状胬肉切除术后并发角巩膜病变的可能原因及相应治疗对策。方法对2009年12月至2013年5月期间于安徽省第二人民医院就诊的6例(6只眼)翼状胬肉切除术后并发角巩膜病变患者的病史、相关检查和治疗等资料进行回顾性分析。结果 6例翼状胬肉患者术后并发角巩膜病变,其中2例发生角膜溃疡,分别为真菌性角膜炎和病毒性角膜炎所致;1例患者胬肉病灶切除位置烧灼引起巩膜变薄、溶解;1例患者术后发生巩膜病变,检查发现免疫指标升高;1例患者术后发生角膜脓肿,检查发现结膜囊G+杆菌阳性;1例患者有高血压,脑梗塞,术后发生角膜溃疡。结论单纯胬肉切除、术中烧灼过度、全身抵抗力下降、自身免疫功能异常,不规范用药、术后护理不当,是翼状胬肉并发角巩膜病变的主要原因。注重全身因素影响、加强术后眼部卫生护理,翼状胬肉切除联合角膜缘干细胞移植术后及时复查治疗可避免术后严重并发症。

Objetive To investigate the possible reason and therapy fi）r complications of the cornea or selera after ptelTguim exeision. Methods Retrospective analysis were conducted about six eases （six eyes） with complications of the cornea or sclera after pterygnim excision, which were performed surgeries in The Anhui Second Provincial People＇s Hospital from December 2009 to May 2013. Results Complications of cornea or sclera were observed in six cases including funga] keratitis, viral keratitis, sclera melting due to cauterization in surgery, immune index increased due to leueitis, corneal abscess with gram positive bacillus in eonjunetival sac, corneal ulcer with hypertension and cerebral infarction .Conclusions The main reasons, which caused complications of cornea or sclera after pteryguim excision, inelude simple pterygium excision, excessive intraoperative cauterization, declined body resistance, autoimnmne disorders, drug abuse, improper postoperative nursing. Severe complications after operation can be avoided if attention were paid to systemic factors, postoperative nursing and timely follow-up.