角膜缘干细胞移植对于翼状胬肉手术患者视力与泪膜功能的影响

Effects of limbal stem cell transplantation on visual acuity and tear film function in patients undergoing pterygium surgery

目的探讨角膜缘干细胞移植对于翼状胬肉手术患者视力与泪膜功能的影响。方法88例翼状胬肉患者,以随机数字表法分为研究组与对照组,每组44例。对照组行翼状胬肉切除术治疗,研究组在对照组基础上联合角膜缘干细胞移植治疗。比较两组治疗前后裸眼视力(UCVA)与角膜散光度(CAD)、泪膜功能[泪液分泌试验(SⅠT)与泪膜破裂时间(BUT)]、眼表疾病指数量表(OSDI)评分,术后并发症发生情况、复发情况。结果治疗前,两组UCVA与CAD比较差异无统计学意义(P>0.05);治疗后,研究组UCVA(0.68±0.05)LogMAR高于对照组的(0.56±0.08)LogMAR,CAD(0.52±0.05)D低于对照组的(0.90±0.08)D,差异具有统计学意义(P<0.05)。治疗前,两组SⅠT与BUT比较差异无统计学意义(P>0.05);治疗后,研究组SⅠT(13.82±0.40)mm/5 min与BUT(13.75±0.26)s均长于对照组的(12.40±0.52)mm/5 min、(12.69±0.38)s,差异具有统计学意义(P<0.05)。研究组术后并发症发生率为4.55%,低于对照组的20.45%,差异具有统计学意义(P<0.05)。治疗前,两组OSDI评分比较差异无统计学意义(P>0.05);治疗后,研究组患者的OSDI评分(10.23±3.98)分显著低于对照组的(17.32±3.56)分,差异具有统计学意义(P<0.05)。随访6个月,研究组复发2例(4.55%),对照组复发9例(20.45%)。研究组术后复发率低于对照组,差异具有统计学意义(χ~2=5.091,P=0.024<0.05)。结论角膜缘干细胞移植能够有效改善翼状胬肉患者的视力与泪膜功能,降低术后并发症与复发率,保障其生活质量,具有临床应用价值。

Objective To discuss the effects of limbal stem cell transplantation on visual acuity and tear film function in patients undergoing pterygium surgery.Methods A total of 88 patients with pterygium were divided into the research group and the control group by random numerical table,with 44 cases in each group.The control group was treated with pterygium resection,and the research group was treated with limbal stem cell transplantation on the basis of the control group.Both groups were compared in terms of uncorrected visual acuity(UCVA)and corneal astigmatism(CAD),tear film function[SchirmerⅠtest(SⅠT)and tear film break-up time(BUT)],ocular surface disease index(OSDI)score before and after treatment,postoperative complications,and recurrence.Results Before treatment,there was no statistically significant difference in UCVA and CAD between the two groups(P>0.05).After treatment,the UCVA(0.68±0.05)LogMAR of the research group was higher than(0.56±0.08)LogMAR of the control group,and the CAD(0.52±0.05)D was lower than(0.90±0.08)D of the control group.All the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in SⅠT and BUT between the two groups(P>0.05).After treatment,both SⅠT(13.82±0.40)mm/5 min and BUT(13.75±0.26)s in the research group were longer than(12.40±0.52)mm/5 min and(12.69±0.38)s in the control group,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the research group was 4.55%,which was lower than 20.45%in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in OSDI score between the two groups(P>0.05).After treatment,the OSDI score(10.23±3.98)points of the research group was significantly lower than(17.32±3.56)points of the control group,and the difference was statistically significant(P<0.05).During the 6-month follow-up,2 patients(4.55%)in the research group relapsed,and 9 patients(20.45%)in the control group relapsed.The postoperative recurrence rate of the research group was lower than that of the control group,and the difference was statistically significant(χ~2=5.091,P=0.024<0.05).Conclusion Limbal stem cell transplantation can effectively improve the visual acuity and tear film function of patients with pterygium,reduce the postoperative complications and recurrence rate,and ensure the quality of life,which contains the value of clinical promotion.