翼状胬肉切除联合自体角膜缘干细胞移植手术对患者眼表及泪膜功能的影响研究

Effect of Pterygium Excision combined with Limbal Stem Cell Autograft on Ocular Surface and Tear Film Function

目的探讨翼状胬肉切除联合自体角膜缘干细胞移植手术对患者眼表及泪膜功能的影响。方法选取我院(2017年1月至2019年1月)收治的116例(116眼)翼状胬肉患者,根据不同治疗分为2组,对照组(n=58)接受翼状胬肉切除术治疗,观察组(n=58)在对照组基础上接受自体角膜缘干细胞移植手术治疗,对比2组患者手术前后视觉质量[角膜散光度(CAD)、裸眼视力(UCVA)]、泪膜破裂时间(BUT)、(泪液分泌SIt)试验、泪液羊齿状物试验(MFT)以及术后并发症(炎性反应、烧灼感、异物感、结膜充血)和胬肉复发率。结果手术前后2组患者CAD、UCVA对比无差异(P>0.05);术后7 d、30 d 2组患者CAD明显降低,UCVA明显升高(P<0.05)。手术前后2组患者SIt对比无差异(P>0.05);术后7 d对照组BUT明显低于观察组(P<0.05);2组患者术前和术后30 d BUT对比无差异(P>0.05)。术前2组患者MFT对比无差异(P>0.05);术后7 d、30 d 2组患者MFTⅠ、Ⅱ级比例明显增加,且观察组Ⅰ、Ⅱ级比例明显高于对照组(P<0.05)。2组患者术后均出现了流泪、眼痛等不适症状,1 d后减轻,术后7 d 2组患者并发症发生率和对比差异明显(P<0.05);随访1个月,2组患胬肉复发率对比差异明显(P<0.05)。结论翼状胬肉切除联合自体角膜缘干细胞移植手术对患者眼表及泪膜功能的具有积极的影响,能促进泪膜功能恢复,降低术后并发症和胬肉复发率。

Objective To investigate the effect of pterygium excision combined with limbal stem cell autograft on the ocular surface and tear fi lm function.Methods 116 cases(116 eyes)of pterygium in our hospital from January 2017 to January 2019 were divided into two groups according to different treatments.The control group(n=58)received pterygium resection,and the observation group(n=58)received limbal stem cell autograft on the basis of the control group.The visual quality(corneal astigmatism(CAD),naked eye)before and after operation were compared between the two groups.Visual acuity(UCVA),tear rupture time(but),tear secretion sit,tear amniotic tooth test(MFT),postoperative complications(inflammatory response,burning sensation,foreign body sensation,conjunctival congestion)and recurrence rate of pterygium.Results There was no difference in CAD and UCVA between the two groups before and after the operation(P>0.05);CAD was signifi cantly lower and UCVA was signifi cantly higher in the two groups 7 and 30 days after the operation(P<0.05).There was no difference in sit between the two groups before and after operation(P>0.05);but in the control group was signifi cantly lower than that in the observation group(P<0.05)on the 7th day after operation;there was no difference between the two groups before and 30 days after operation(P>0.05).There was no difference in MFT between the two groups before operation(P>0.05);the proportion of MFTⅠandⅡin the observation group was signifi cantly higher than that in the control group(P<0.05).The incidence of complications and the difference between the two groups were signifi cant(P<0.05)7 days after operation,and the difference between the two groups was signifi cant(P<0.05).Conclusion Pterygium excision combined with limbal stem cell autograft has a positive effect on ocular surface and tear film function,which can promote tear film function recovery,reduce postoperative complications and recurrence rate of pterygium.