翼状胬肉的个体化手术疗效分析

Analysis on the effect of individual operation procedure for the treatment of pterygium

目的探讨对不同的翼状胬肉选择相应的个体化手术方式的治疗效果。方法根据翼状胬肉是否为复发性和受累的角膜缘组织范围选择手术方式，观察其术后症状，角膜创面愈合速度和复发率。结果20例（23眼）复发性翼状胬肉行胬肉切除＋羊膜移植＋自体角膜缘干细胞移植，复发2眼，复发率8．7％。32例（42眼）初发者受累角膜缘组织小于2个钟点者行胬肉切除联合结膜瓣转位术，复发5眼，复发率11．9％。35例（38眼）初发者受累角膜缘组织大于2个钟点者行胬肉切除＋自体角膜缘干细胞移植，复发4眼，复发率10．5％术。3组患者术后角膜创面愈合时间无明显差别，随诊6～7个月，3组患者复发率差异无统计学意义（P〉0．05）。结论对翼状胬肉不同的情况选择个体化的手术方案能获得较好的手术效果，手术方案的选择根据是否为复发胬肉和受累的角膜缘范围。

Objective To analyse the effect of individual operation procedure for pterygium. Methods The pterygium patients received different operation procedures according to the recurrence or not and their corneal limbal condition. The corneal healing and recurrence rates were observed. Results Twenty-three eyes of 20 patients with recurrent pterygium underwent pterygium excision with amniotic membrane transplantation and limbal auto-graft transplantation and 2 eyes reoccurred with the recurrent rate of 8.7%. Forty-two eyes of 32 patients with involved corneal limbus less than two o＇clocks received pterygia excision combined with conjunctiva-flap translocation and 5 eyes reoccurred with the recurrent rate of 11.9%. Thirty-eight eyes of 35 patients with involved corneal hmbus more than two o＇clocks were given pterygia excision and limbal auto-graft transplantation and 4 eyes reoccurred with the recurrent rate of 10.5%. The difference in the recurrent rate between the three groups was not statistically significant after the follow-up of 6-7 months （ P 〉 0.05 ）. Conclusion The individual operation procedure for pterygium could get good result. The selection of surgical procedure is according to the recurrence or not and their corneal limbal condition.