翼状胬肉大小与术后恢复的关系

Relationship between pterygium size and postoperative recovery

目的研究翼状胬肉大小与术后恢复的关系。方法回顾性分析我院2016年1月至2018年1月收治的原发性翼状胬肉患者150例(150眼)的临床资料,根据翼状胬肉的大小(即侵入角膜缘内的位置)将患者分为三级,分别设为A(Ⅰ级)、B(Ⅱ级)、C组(Ⅲ级),各50例(50眼)。比较三组患者手术前、手术后6个月的裸眼视力、散光度、术后角膜上皮修复时间、术后不良反应、并发症发生情况及复发率。结果手术前,A组的裸眼视力高于B组及C组,且B组高于C组(P<0.05);手术后6个月,A组的裸眼视力高于B组及C组,且B组高于C组(P<0.05);手术后6个月,三组患者的裸眼视力均高于手术前(P<0.05)。手术前,A组的散光度低于B组及C组(P<0.05);手术后6个月,A组的散光度低于B组及C组,且B组低于C组(P<0.05);手术后6个月,三组患者的散光度均低于手术前(P<0.05)。A组的术后角膜上皮修复时间短于B组及C组,且B组短于C组(P<0.05)。A组与B组的复发率比较,差异无统计学意义(P>0.05);B组与C组的复发率比较,差异无统计学意义(P>0.05);A组患者的复发率显著低于C组(P<0.05)。结论翼状胬肉侵入角膜的大小影响着患者的视力以及手术后的复发率,翼状胬肉侵袭角膜的范围越大,对患者视力的影响越大,手术后的复发率越高。

Objective To study the relationship between the pterygium size and postoperative recovery. Methods The clinical data of 150 cases(150 eyes) of primary pterygium treated in our hospital from January 2016 to January 2018 were retrospectively analyzed. According to the size of pterygium(the position of invasion into the limbal), the patients were divided into three groups: group A(grade Ⅰ), group B( grade Ⅱ) and group C( grade Ⅲ), with 50 cases(50 eyes) in each group. The visual acuity, astigmatism before operation and at 6 months after operation, corneal epithelial repair time,postoperative adverse reactions, complications and recurrence rate of the three groups were compared. Results Before operation, the visual acuity in the group A was higher than that in the group B and group C, and that in the group B was higher than that in the group C(P<0.05);at 6 months after operation, the visual acuity in the group A was higher than that in the group B and group C, and that in the group B was higher than the group C(P<0.05);at 6 months after operation, the visual acuity in the three groups were higher than those before operation(P<0.05). Before operation, the astigmatism of the group A was lower than that of the group B and group C(P<0.05);at 6 months after operation, the astigmatism of the group A was lower than that of the group B and group C, and that of the group B was lower than the group C(P<0.05);at 6 months after operation, the astigmatism of three groups were lower than those before operation(P<0.05). The time of corneal epithelial repair in the group A was shorter than that in the group B and group C, and that in the group B was shorter than the group C(P<0.05). There was no significant difference in the recurrence rate between the group A and group B(P>0.05);there was no significant difference in the recurrence rate between the group B and group C(P>0.05);the recurrence rate of the group A was significantly lower than that of the group C(P<0.05). Conclusion The size of pterygium invading the cornea affects the visual acuity of patients and the recurrence rate after operation. The larger the range of pterygium invading cornea, the greater the impact on the visual acuity of patients, the higher the recurrence rate after operation.