自体角膜缘干细胞移植联合羊膜移植治疗复发性翼状胬肉的疗效观察

Observation of autologous limbal stem cell transplantation combined with amniotic membrane transplantation in the treatment of recurrent pterygium

目的探讨自体角膜缘干细胞移植联合羊膜移植术治疗复发性翼状胬肉的临床效果。方法选取60例(73眼)复发性翼状胬肉患者为研究对象,按照数字随机法分为观察组(30例,38眼)和对照组(30例,35眼),对照组采用羊膜移植术,观察组采用自体角膜缘干细胞结膜植片联合羊膜移植术。术后随访12个月,分析比较两种术式的临床效果、复发率及并发症。结果两组患者的手术时间无明显差异(P>0.05),术后23周羊膜逐渐溶解、吸收。观察组角膜上皮愈合时间低于对照组(P<0.05);所有患者均获得随访,术后未出现角膜、巩膜溃疡,睑球粘连以及眼球活动受限等并发症。观察组2眼(5.3%)翼状胬肉复发,对照组4眼(11.4%)复发,观察组复发率显著低于对对照组(P<0.05),具有统计学意义。结论自体角膜缘干细胞移植联合羊膜移植治疗不会影响原术眼局部组织结构,可缩短角膜上皮愈合时间,降低翼状胬肉复发率。

Objective To investigate the method and observe effectiveness of autologous limbal stem cell transplantation com-bined with amniotic membrane transplantation in the treatment of recurrent pterygium. Methods Total 60 patients （73 eyes） were analyzed in our study. All patients were divided into observation group （30 cases,38 eyes） and control group （30 cases,35 eyes）. The patients in observation group received autologous limbal stem cell transplantation combined with amniotic membrane trans-plantation while the control group received amniotic membrane transplantation. All patients were followed up 12 months ,compare the clinical effect,complications and recurrence rate between two groups. Results The average operation time had no obvious dif-ference between two groups（P〉0.05）,and the amniotic membrane were dissolution,absorption during 2-3 weeks. the repair time of corneal epithelium of observation were shorter than control group （P〈0.05）. All patients were followed up,and there were no severe complications post surgery. There were 2 eyes and 4 eyes had pterygium recurrence in observation group and control group respec-tively,and the recurrent rate of observation group were lower than control group（P〈0.05）. Conclusion The treatments of autologous limbal stem cell transplantation combined with amniotic membrane transplantation could lower the repair time of corneal epitheli-um and alleviate the patient＆#39;s symptoms,it also could reduce the recurrence rate remarkably,it was a safe and effective surgical operation method to cure the recurrent pterygium.