新鲜羊膜移植联合治疗性软性角膜接触镜在治疗翼状胬肉中的应用

Application of fresh amniotic membrane transplantation combined therapeutic soft corneal contact lens in pterygium

目的:探讨新鲜羊膜移植联合治疗性软性角膜接触镜在治疗翼状胬肉中的临床效果,并总结其临床价值。方法:回顾性分析2010-01/2011-06在我院行翼状胬肉切除联合新鲜羊膜移植术患者200例220眼,其中100例110眼联合配戴治疗性软性角膜接触镜(试验组),其余患者作为对照组(100例110眼),并对两组患者术后的临床效果进行比较分析。结果:对照组术后角膜上皮修复时间为2～7(平均3.8)d,术后随访观察6～18mo,有9眼复发,复发率为8.2%;试验组术后角膜上皮修复时间为1～5(平均2.5)d,随访观察6～18mo,其中有5眼复发,复发率为4.5%,两组疗效比较,差异有统计学意义(P<0.05)。同时,我们也发现配戴角膜接触镜后术后早期刺激症状明显减轻。结论:翼状胬肉切除联合羊膜移植并配戴治疗性软性角膜接触镜的术后临床效果明显优于翼状胬肉切除联合新鲜羊膜移植术。配戴治疗性软性角膜接触镜可缩短术后角膜上皮的修复时间,可有效降低翼状胬肉术后的复发率,并且可以在一定程度上缓解术后因角膜上皮缺损而导致的畏光、流泪、异物感及眼痛等术后刺激症状。

AIM： To evaluate the clinical effect of therapeutic soft corneal contact lens in combination with fresh amniotic membrane transplantation in the treatment of pterygium and its clinical value.METHODS： This study was a retrospective analysis of200 pterygium excision patients（ 200 cases,220 eyes） in hospital from January 2010-June 2011. The patients were divided into two groups. Group 1（ 100 cases,110 eyes）were patients treated with fresh amniotic membrane transplantation and therapeutic soft corneal contact lens while group 2（ control group,100 cases,110 eyes） did not use corneal contact lens. The clinical outcomes in these two groups were compared in a 6- 18 mo postoperative follow-up observation.RESULTS： In control group using corneal contact lens the epithelium repair time ranged from 2- 7d with an average time of 3.8d; in group 1 the epithelial repair time ranged from 1- 5d with an average time of 2. 5d. The patients were followed up for 6- 18 mo,9 recurrent eyes were found in control group,the recurrence rate was8. 2%; 5 recurrent eyes were found in experimental group the recurreat rate was 4. 5%. There were significant differences in the 2 groups comparing treatment outcomes（ P〈0.05）. Early stimulative symptoms after surgery can be reduced by wearing contact lenses.CONCLUSION： The therapeutic effect of fresh amniotic membrane transplantation after pterygium excision is enhanced by the therapeutic application of corneal contactlens. The epithelial repair time is shortened, the recurrence rate is reduced after pterygium excision and stimulative symptoms including photophobia, tearing,foreign body sensation and ophthalmodynia caused by corneal epithelial defect can be relieved.