自体角膜缘干细胞移植术与结膜瓣转位术治疗初发性翼状胬肉的临床分析

Clinical analysis of limbal stem cell transplantation and conjunctival flap rotation in treatment of primary pterygium

目的：比较自体角膜缘干细胞移植术和结膜瓣转位术治疗初发性翼状胬肉的临床疗效。方法：将85例（97眼）初发性翼状胬肉患者随机分为A、B两组。 A组患者（50眼）：行自体角膜缘干细胞移植术,术后随访19-24个月,平均（20.24±0.25）个月；B组患者（47眼）：行结膜瓣转位术,术后随访18-24个月,平均（19.75±0.38）个月。比较两组患者术后恢复情况、复发率以及角膜散光情况。结果：两组患者术后均恢复良好,无并发症发生。 A组患者失访5眼,4眼复发,复发率为8.89％；B组患者失访4眼,5眼复发,复发率为11.63％；两组患者比较x^2=0.03,P〉0.05,差异无统计学意义。两组患者术后散光度数分别为（0.76±0.68）D 和（0.82±0.60）D ,两组间比较,t=0.0.438, P〉0.05,差异无统计学意义。结论：自体角膜缘干细胞移植术与结膜瓣转位术均可有效的治疗翼状胬肉,尚不能认为在术后复发率和术后散光矫正方面,两种手术方式存在差异。

Objective：To compare the efficacy of limbal stem cell transplantation and conjunctival flap rotation in the treatment of primary pterygium. Methods：85 patients （97 eyes） with primary pterygium were randomly divided into group A （50 eyes） treated with limbal stem cell transplantation and group B （47eyes） treated with conjunctival flap rotation combined. Group A was followed-up for 19-24 months with an average of （20. 24±0. 25） months, while group B was followed-up for 18-24 months with an average of （19. 75±0. 38） months. The recovery, recurrence rate and corneal astigmatism of the two groups were compared. Results：The patients in the two groups recovered well without any complications. In group A, 5 eyes missed the follow up, and 4 eyes recurred with the re-currence rate of 8. 89%;while in group B, 4 eyes missed the follow up, and 5 eyes recurred with the recurrence rate of 11. 63%;no statistical significance was found between the two groups regarding the recurrence rates （x2=0. 03, P〉0. 05）. The astigmatism specta-cle of two groups patients after the operation were 0. 76 ± 0. 68D and 0. 82 ± 0. 60D, and there was no significant difference between the two groups （t=0. 0. 438, P〉0. 05）. Conclusions：Limbal stem cell transplantation and conjunctival flap rotation are both effective method for the treatment of pterygium. It is not considered the two kinds of operation modes are different in the postoperative recurrence rate and postoperative astigmatism correction.