带角膜缘干细胞结膜瓣移植治疗翼状胬肉效果观察

Efficacy observation on limbal stem cell transplantation in treatment of pterygium conjunctival flap

目的：观察使用带角膜缘干细胞结膜瓣移植治疗翼状胬肉对预防胬肉复发的作用。方法选取我院住院及门诊2010年8月至2012年12月诊断翼状胬肉的患者作为研究对象，共86例107眼。其中男30例39眼，女56例68眼，静止期26例33眼，活动期60例74眼，均位于鼻侧，年龄最高76岁，最低31岁，病程2年至20余年不等。手术方法：将胬肉从角膜面完全切除，不残留纤维组织及血管，分离、切除胬肉下增生肥厚组织至泪阜处，取术眼上方结膜瓣：视胬肉大小取带2～3 mm角膜缘干细胞的结膜瓣，以稍大于胬肉切除区域为宜，将结膜瓣用10／0不可吸收外科缝线缝合于植床上。结果86例107眼翼状胬肉随访12月至18个月，3例复发。结论使用带角膜缘干细胞结膜瓣移植治疗翼状胬肉手术操作简单，角膜创面恢复良好，特别在预防复发方面有较大优势，值得推广。

Objective Effects observed with the use of limbal stem cell transplantation in the treatment of pterygium conjunctival flap for the prevention of recurrence of pterygium.Methods Chosen the diagnosis of pterygium patients as research subjects in our hospital inpatient and outpatient from August 2010 to December 2012, a total of 86 cases （107 eyes）, including 30 males in 39 cases, 56 females in 68 cases.26 cases （33eyes） were in stationary phase, and 60 cases（74eyes） were in active, which age was 31 to 76 range.Surgical method：The complete excision of pterygium from the cornea surface, no residual fibrous tissue and blood vessels, separation, removal of tissue under the pterygium hypertrophy to tears at the mound, taking the top eye surgery conjunctival flap：as pterygium size to take with 2～3mm limbal stem cells conjunctival flap, slightly larger than the area of pterygium excision was appropriate, the conjunctival flap with 10/0 non-absorbable surgical sutures in the planting bed.Results 86 cases （107 eyes） followed up in 12 to 18 months, three cases were recurrence. Conclusions Simply used with limbal stem cell transplantation in the treatment of pterygium surgery with conjunctival flap operation can give a well corneal wound healing; especially a greater advantage in terms of relapse prevention, which is worth promoting.