眼表重建术治疗翼状胬肉219例分析

Ocular surface reconstruction for treatment of 219 cases of pterygium

目的探讨眼表重建术治疗翼状胬肉的手术方法及其效果。方法4年来手术治疗的翼状胬肉219例（239眼）。原发性215眼，继发性24眼。手术切除翼状胬肉后，同眼健侧取宽1mm角膜缘板层并带有结膜的移植片，对位移植于创区进行眼表重建。结果术后观察3月～4年，原发性翼状胬肉术后复发率3．26％，继发性者复发率4．17％，总复发率3．35％，低于其它手术。未复发病例中，术后眼表基本恢复正常，复发病例未行二次手术，仍在观察中。结论角膜干细胞联合结膜移植，可使翼状胬肉病变区眼表结构修复正常，减少复发，是治疗翼状胬肉的较好方法。

Objective To investigate the surgical method and its clinical efficacy of ocular surface reconstruction for pterygium. Methods In last 4 years, 239 eyes of 219 patients who underwent pterygium surgery were chosen, including 215 eyes of primary pterygium and 24 eyes of secondary pterygium. After surgical removal, 1 mm wide corneal limbus lamina with conjunctiva from the same eye was transplanted to rebuild ocular surface. Results The recurrence rate of the primary pterygium was 3.26%, and that of secondary pterygium was 4.17% at 3 months to 4 years after surgery. The total recurrence rate was 3.35% , and was lower than that of other surgeries. In those cases without recurrence, patient＇ s ocular surface was almost normal. The recurrent patients did not receive surgery again, and were still under observation. Conclusion The corneal stem cells with conjunctiva transplantation can normalized ocular surface structure damaged by pterygium, and reduce relapse. It is a good method to treat pterygium.