翼状胬肉手术不同切除范围效果分析

Analysis on the efficacy of different exsection range in pterygium

目的分析翼状胬肉切除联合自体球结膜移植术中胬肉体部不同手术切除范围的效果。 方法回顾性分析2016年7月至2017年1月翼状胬肉手术86例（86眼）的临床资料，2眼为复发性翼状胬肉。患者随机分为两组：A组，44眼，采用翼状胬肉大范围切除联合眼球筋膜囊组织完全清除；B组，42眼，仅切除增生比较明显的体部病变部位，尽可能保留显微镜下形态正常的眼球筋膜囊组织。术后随访1年，对比分析两组的复发率、效果及并发症情况。 结果两组患者术前翼状胬肉侵入角膜的相对长度、相对宽度、年龄等差异无统计学意义（P＝0.247，0.185，0.125）。A组术后植床区域球结膜组织出现反复充血症状3眼；B组术后植床区域球结膜组织反复充血伴植床与植片吻合区域明显瘢痕显露10眼，随访期末，5眼出现结膜组织纤维血管增生，复发率11.9%。两组患者均无其他严重并发症发生。 结论翼状胬肉大范围切除联合眼球筋膜囊组织切除在控制术后复发、改善患者球结膜充血症状方面具有一定优势。

ObjectiveTo analyse the efficacy of different exsection range in pterygium excision combined with conjunctival limbal autograft transplantation. MethodsThe clinical data of 86 eyes of 86 patients with ptergium, from Jan. 2016 to Jan. 2017 were analyzed retrospectively.Among them 2 cases were recurrent pterygium. All cases were divided into 2 groups randomly.Group A, 44 cases, treated with pterygium extended excision combined with Tenon’s capsule excision.Group B, 42 cases, received obvious hyperplasia pterygium excision only.The follow-up time was 1 year.Postoperative recurrence rates, efficacy and complications between both groups were compared and analyzed. ResultsThe difference of length, width of pterygium invaded the cornea and the age of onset were not statistically significant between the two groups （P=0.247, 0.185, 0.125）. In group A, the conjunctival of grafting bed occurred persistent congestion in 3 eyes after surgery. At the end of follow up, no recurrent or scar exposure occured.In group B, there were 10 cases with repeated conjunctival congestion in grafting bed. The conjunctival fibrovascular tissue proliferation and significant scar tissue exposure occured in 5 eyes（11.9%）. ConclusionPterygium extended excision combined with Tenon’s capsule excision is an efficient method for pterygium.It may reduce recurrence and improve postoperative conjunctival congestion.