两种翼状胬肉切除术配戴绷带式角膜接触镜的临床效果观察

Clinical observation of two kinds of pterygium excision combined with wearing the bandage corneal contact lens

目的探讨两种翼状胬肉切除术配戴绷带式角膜接触镜的临床应用价值。方法选取2016年3月～2017年12月我院收治的80例(160眼)双眼患翼状胬肉患者,按照不同术式分为A组与B组,每组40例(80眼)。A组行改良式单纯翼状胬肉切除术,B组行翼状胬肉切除术联合球结膜移植术,两组术后均配戴绷带式角膜接触镜。对比两组手术用时、角膜上皮愈合时间、术后第1 d眼部刺激症状(异物感、眼部刺痛、流泪、睁眼困难),术后随访3个月,对比两组复发、角膜溃疡、结膜肉芽肿、巩膜溶解等发生情况及视力改善情况。结果 A组手术用时短于B组(P<0.05),角膜上皮愈合时间与B组比较无显著差异(P>0.05);术后第1 d A组异物感、眼部刺痛、流泪、睁眼困难评分低于B组(P<0.05);术后随访3个月,两组均未发生角膜溃疡、结膜肉芽肿、巩膜溶解及复发;术后3个月两组角膜散光度、角膜曲率及裸眼视力较手术前改善(P<0.05),但两组间比较仍无显著差异(P>0.05)。结论两种翼状胬肉切除术配戴绷带式角膜接触镜均能改善患者视力情况,且改良式单纯翼状胬肉切除术手术用时短,且术后眼部刺激症状轻,在非复发性翼状胬肉中更具应用价值。

Objetive To explore clinical application value of two kinds of pterygium excision combined with wearing the bandage corneal contact lens. Methods 80 cases （160 eyes） of pterygium patients in our hospital from March 2016 to December 2017 treated with pterygium excision were divided into group A and group B, with 40 cases （80 eyes） in each group. Group A underwent modified pterygium excision and group B underwent pterygium excision combined with conjunctival transplantation. Patients in both groups all wear bandage corneal contact lens after operation. The operation time, corneal epithelial healing time, eye irritation （foreign body sensation, eye pain, tears, difficulty in opening eyes） after 1 d of operation were compared between the two groups. The follow-up period was 3 months. The recurrence, corneal ulcer, conjunetival granuloma, scleral lysis and visual acuity were compared between the two groups. Results The operation time in group A was shorter than that in group B （ P 〈 0.05 ） . There was insignificant difference in healing time of corneal epithelium between group A and group B （ P 〉 0.05 ） . At the first d after operation, the scores of foreign body sensation, eye pain, tears and eye opening difficulty in group A were lower than those in group B （ P 〈 0.05 ） . After 3 months of follow- up, no corneal ulcer, conjunetival granuloma, scleral dissolution and recurrence were found in the two groups, andcorneal astigmatism, corneal curvature and naked eye vision of two groups were improved in 3 months after the operation （ P 〈 0.05 ） , but the difference was insignificant （ P〉 0.05. Conclusion Two kinds of pterygium excision combined with wearing the bandage corneal contact lens can improve the visual acuity of the patients. The modified simple pterygium excision operation is short, and the postoperative eye irritation symptoms are light, and it is more valuable in the primary pterygium.