自体角膜缘干细胞移植术与保存人羊膜移植术治疗翼状胬肉患者的效果比较

Comparison of effects of autologous limbal stem cell transplantation and preserved human amniotic membrane transplantation in treatment of pterygium

目的:比较自体角膜缘干细胞移植术与保存人羊膜移植术治疗翼状胬肉患者的效果。方法:选取2020年1月至2021年11月该院收治的66例翼状胬肉患者进行前瞻性研究,按随机数字表法将其分为研究组与对照组各33例。两组均行翼状胬肉切除术,对照组采用保存人羊膜移植术治疗,研究组采用自体角膜缘干细胞移植术治疗,比较两组手术前后视力、散光度、视觉质量(角膜垂直曲率、角膜水平曲率)、泪膜功能[泪膜破裂时间(BUT)、泪液分泌试验(SIT)]、并发症发生率和复发率。结果:术后2周,研究组视力水平高于对照组,散光度低于对照组,差异有统计学意义(P<0.05);研究组角膜垂直率和角膜水平曲率均高于对照组,差异有统计学意义(P<0.05);研究组BUT水平高于对照组,差异有统计学意义(P<0.05);两组SIT水平比较,差异无统计学意义(P>0.05);研究组并发症发生率和复发率均低于对照组,差异有统计学意义(P<0.05)。结论:自体角膜缘干细胞移植术治疗翼状胬肉患者可提高视力水平、角膜垂直率、角膜水平曲率和BUT水平,以及降低散光度、并发症发生率和复发率,其效果优于保存人羊膜移植术治疗。

Objective:To compare effects of autologous limbal stem cell transplantation and preserved human amniotic membrane transplantation in treatment of pterygium.Methods:A prospective study was performed on 66 patients with pterygium admitted to this hospital from January 2020 to November 2021,and they were divided into study group and control group according to the random number table method,33 cases in each.Pterygium excision was performed in the two groups.The control group was treated with preserved human amniotic membrane transplantation,while the study group was treated with autologous limbal stem cell transplantation.The visual acuity,the astigmatism degree,the visual quality(vertical corneal curvature and horizontal corneal curvature)level,the tear film function[tear breakup time(BUT),Schirmer test(SIT)]level,the incidence of complications,and the recurrence were compared between the two groups before and after the surgery.Results:2 weeks after the surgery,the visual acuity level of the study group was higher than that of the control group;the astigmatism degree was lower than that of the control group;and the differences were statistically significant(P<0.05).The corneal vertical rate and the corneal horizontal curvature in the study group were higher than those in the control group,and the differences were statistically significant(P<0.05).The BUT level of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the SIT level between the two groups(P>0.05).The incidence of complications and recurrence rates in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusions:Autologous limbal stem cell transplantation for the pterygium patients can improve the visual acuity,the corneal vertical rate,the corneal horizontal curvature and the BUT level and reduce the astigmatism degree,the incidence of complications and the recurrence rate.Moreover,it is superior to preserved human amniotic membrane transplantation.