不同方式丝裂霉素C的应用联合手术治疗复发性翼状胬肉

Effect of subconjunctival mitomycin C combined with surgical treatment on recurrent pterygium

目的探讨不同方式丝裂霉素C(MMC)的应用联合手术治疗复发性翼状胬肉的疗效和安全性。方法将44例患者49眼随机分成A、B两组,A组25眼采用术前1月结膜下注射0.1 ml MMC(0.02%)联合翼状胬肉单纯切除术,B组24眼采用翼状胬肉切除+MMC(0.02%)+角膜缘干细胞移植术,术后随访12个月。结果 A组复发3眼,复发率12.0%,B组复发4眼,复发率16.7%,2组差异无统计学意义(P>0.05)。A组1眼出现胬肉切除区巩膜无血管化,B组2眼发生持续性角膜上皮缺损,2组差异无统计学意义(P>0.05)。结论 2种方法治疗复发性翼状胬肉均安全有效,但术前1月结膜下注射0.1 ml MMC(0.02%)联合翼状胬肉单纯切除术具有操作简单、手术时间短和结膜组织损伤少等优点,值得临床推广应用。

Objective To observe the clinical outcomes and safety of Surgical Treatment with Subconjunctival Mitomycin C （MMC） on recurrent pterygium. Methods A total of 49 eyes of 44 patients with recurrent pterygium were randomly di- vided into two groups. 25 eyes in Group A received subconjunctival injection of 0.1 ml of 0.02% MMC 1 month before pterygium excision,whine 24 eyes in group B received pterygium excision with intraoperative 0.02% MMC and limbal- conjunctival autograft transplantation. All patients were followed up for 12 months. Results The recurrence rate was 12.0% in Group A （3/25） and 16.7% in Group B （4/24）, the difference between the two groups was not significant （ P 〉 0.05 ） ; there was 1 case of hypovascularity at the site of pterygium excision in Group A, whereas 2 cases of persistent corneal epithelial defects in Group B ,there was no significant difference in the incidence of complications between the two groups （ P 〉 0.05 ）. Conclusion Both techniques used in the current study are proved to be safe and effective for the re- current pterygium. Subconjunctival injection of 0.1 ml of 0.02% MMC 1 month before pterygium excision was technically easier for operation, with shorter operative time and preservation of healthy conjunctiva, it was worthy of clinical applica- tion.