雷珠单抗辅助自体角膜缘干细胞移植在复发性翼状胬肉手术中的应用

Use of Ranibizumab with Corneal Limbal Stern Cell Autograft for Management of Recurrent Pterygium

目的评价雷珠单抗(Lucentic)在复发性翼状胬肉手术治疗中的临床疗效。方法回顾分析46只翼状胬肉眼的临床资料,分为治疗组20只眼,采用胬肉切除联合角膜缘干细胞移植术,术中结膜下注射雷珠单抗(0.5mg/0.05ml)。对照组26只眼,单纯采用胬肉切除联合角膜缘干细胞移植术。结果随访6个月治疗组与对照组平均视力均较术前提高,两者差异无统计学意义(P>0.05)。平均眼压、角膜内皮细胞数量与术前比较差异均无统计学意义(P>0.05)。复发率:治疗组无复发,对照组有3例复发,两者差异有统计学意义(P<0.05)。治疗组部分患者术后一天出现局部组织缺血现象,但术后2周自愈。两组均无角膜上皮缺失、糜烂、角膜变薄等并发症发生。结论雷珠单抗联合角膜缘干细胞移植术可有效抑制复发性翼状胬肉的复发,未见明显并发症。

Objective To evaluate the clinic efect of Ranibizumab with corneal limbal stem cell autograft for management of recurrent pterygium.Methods The retrospective clinical study was performed in 46 eyes with recurrent pterygium.These patients were allocated into two groups：treatment Group（20 eyes） operated by pterygium excision and comeal limbal stem cell autograft with Ranibizumab by intraoperative sub——conjunctival injection,and control group （26 eyes） operated by pterygium excision and corneal limbal stem cell autograft without Ranibizumab.Results In follow up of 6 months,the mean visual acuity of treatment group and control group were improved,and the difference was not statistically significant （P ＞ 0.05）.There was no significant difference （P ＞ 0.05） in intraocular pressure and corneal endothelial cell density between preoperative and postoperative.Patients from treatment group showed conjunctival autograft ischaemia at 24 h postoperative,which disappeared by the second postoperative week.It was significantly different between treatment group with no recurrence and control group with 3 cases of recurrence （P ＜ 0.05）.Two groups of stern cell grafts survived well,and there was no complications such as corneal epithelial loss,erosion and corneal thinning.Conclusion Ranibizumab combined with corneal limbal stem call autograft can effectively inhibit recurrent pterygium recurrence,no obvious complications.