翼状胬肉切除联合自体角膜缘干细胞移植对创面上皮修复及复发的影响

Study on the influence of pterygium excision combined with corneal limbal stem cell transplantation for the recovery of epithelia and recurrence

目的探讨翼状胬肉切除联合自体角膜缘干细胞移植对创面上皮修复及复发的影响。方法选择2011年11月至2015年6月收治的翼状胬肉患者,共162例202眼,在翼状胬肉切除的基础上,分别联合自体角膜缘干细胞移植(A组)82例101眼,生物羊膜移植(B组)80例101眼。比较两组的手术前后视力变化、创面愈合时间及复发情况。结果两组术后视力、屈光度均显著改善(P<0.05),而术后两组视力、屈光度无显著性差异(P>0.05);与B组比较,A组创面愈合时间明显缩短,术后并发症发生率显著降低(P<0.05);随访6个月,A组复发率为4.0%,显著低于B组11.9%(P<0.05)。结论翼状胬肉切除联合角膜缘干细胞移植可促进创面上皮修复,减少术后并发症,降低术后复发率。

Objective To explore the influence of pterygium excision combined with corneal limbal stem cell transplantation for the recovery of epithelia and recurrence. Methods A total of 162 patients with pterygium in 202 eyes received treatment in this hospital during November 2011 to June 2015 were included in this study. On the basis of pterygium excision,patients in group A（ 82 patients with 101 eyes） were given with corneal limbal stem cell transplantation,and patients in group B（ 80 patients with 101 eyes） were given with biological amnion transplantation respectively. The change of eyesight,wound healing time and recurrence were compared before and after surgery. Results The postoperative eyesight and diopter were significantly improved in patients of both groups compared with those before operation（ P〈0. 05）,while there was no significant difference between these two groups on eyesight and diopter（ P〈0. 05）. In comparison with group B,wound healing time in group A was significantly shortened,and the complication rate was also reduced（ P〈0. 05）. After follow up for 6 months,the recurrence rates of group A and group B were 4. 0% and 11. 9% respectively,and the difference was statistically significant（ P〈0. 05）. Conclusion Excision of pterygium combined with corneal limbal stem cell transplantation can contribute to promote the recovery of epithelia,reduce the postoperative complications and rate of recurrence.