对比自体角膜缘干细胞与生物羊膜移植术治疗翼状胬肉的临床疗效

Comparison of clinical effects of autologous limbal stem cell transplantation and amniotic membrane transplantation on pterygium

目的对自体角膜缘干细胞移植与生物羊膜移植术治疗翼状胬肉的临床疗效进行比较。方法选择2018年1月—2020年6月收治的130例(142眼)翼状胬肉患者作为研究对象,根据患者的治疗方式将其分为两组,其中采用胬肉切除术+自体角膜缘干细胞移植术治疗的65例(70眼)患者为A组,另采用胬肉切除术+生物羊膜移植术治疗的65例(72眼)患者为B组,对两组治疗后的角膜创面愈合时间、角膜散光度和泪膜稳定性及眼红指数进行记录,同时观察患者术后是否存在复发情况。结果A组的角膜创面愈合时间为(4.58±1.04)d,B组为(6.85±1.22)d,两组差异具有统计学意义(P<0.05)。术后1周A组的泪膜稳定性显著优于B组(P<0.05),A组眼红指数显著低于B组(P<0.05)。术后1个月两组的角膜散光度均比治疗前有明显改善,且两组改善程度无明显差异(P>0.05)。术后3个月,A组复发率为3.08%,B组为13.85%,两组差异具有统计学意义(P<0.05)。结论自体角膜缘干细胞与生物羊膜移植术治疗翼状胬肉均可改善患者的角膜散光度,但是自体角膜缘干细胞移植术来源于自体眼表组织,排斥反应较少,更有助于创面愈合并减少复发。

Objective To compare the clinical effects of limbal stem cell transplantation and amniotic membrane transplantation on pterygium.Methods A total of 130 patients(142 eyes)with pterygium admitted from January 2018 to June 2020 were selected as study subjects and autologous were divided into two groups according to treatment methods.The 65 patients(70 eyes)treated with pterygium resection and limbal stem cell transplantation were included in group A,and another 65 patients(72 eyes)treated with pterygium resection and amniotic membrane transplantation were included in group B.Corneal wound healing time,corneal astigmatism,tear film stability,and reactive hyperemia index were recorded,and recurrence after surgery were also observed.Results The corneal wound healing time in the group A[(4.58±1.04)d]was shorter than that in the group B[(6.85±1.22)d](P<0.05).After 1 week of surgery,the tear film stability was significantly better(P<0.05),and the reactive hyperemia index was significantly lower(P<0.05)in the group A than in the group B.After 1 month of surgery,the corneal astigmatisms of the two groups were both improved than before,and there was no significant difference between the two groups(P>0.05).After 3 months of surgery,the recurrence rate in the group A(3.08%)was significantly lower than that in the group B(13.85%)(P<0.05).Conclusion Both autologous limbal stem cell transplantation and amniotic membrane transplantation for the treatment of pterygium can improve patients’corneal astigmatism.However,autologous limbal stem cells are derived from autologous ocular surface tissues and produce fewer rejection reactions,so they are more helpful for wound healing and recurrence reduction.