切除联合自体角膜缘干细胞移植术治疗原发性翼状胬肉的研究

The efficacy and safety of pterygium resection combined with autologous corneal limbal stem cell transplantation for the treatment of primary pterygium

目的探讨翼状胬肉切除联合自体角膜缘干细胞移植术治疗原发性翼状胬肉的临床效果及安全性。方法回顾性研究2019年1月至2023年1月在本院接受原发性翼状胬肉手术治疗的66例患者病历资料,将66例患者根据手术方式的不同分为对照组(n=33,翼状胬肉切除联合游离结膜瓣移植术)及试验组(n=33,翼状胬肉切除联合自体角膜缘干细胞移植术)。比较两组临床效果、术后结膜瓣愈合时间、角膜上皮修复时间,记录术前及术后1个月、3个月、6个月泪膜破裂时间(TBUT)变化及术后并发症发生率和术后6个月的复发率。结果试验组患者治疗后的临床疗效高于对照组,术后结膜瓣愈合时间、角膜上皮修复时间明显短于对照组,术后的1月、3月、6月时TBUT时间明显长于对照组(P<0.05);两组术后并发症的发生率及复发率比较,差异无统计学意义(P>0.05)。结论翼状胬肉切除联合自体角膜缘干细胞移植术治疗原发性翼状胬肉具有良好的治疗效果和安全性,可降低术后复发率,且不增加术后并发症发生率。

Objective To explore the clinical efficacy and safety of pterygium resection combined with autologous corneal limbal stem cell transplantation for the treatment of primary pterygium.Methods A retrospective study was conducted on the medical records of 66 patients who underwent primary pterygium surgery in our hospital from January 2019 to January 2023.66 patients were divided into the control group(n=33,pterygium resection combined with free conjunctival flap transplantation)and the experimental group(n=33,pterygium resection combined with autologous corneal limbal stem cell transplantation),based on different surgical methods.The clinical outcomes,postoperative conjunctival flap healing time,and corneal epithelial repair time were compared.The changes in tear film rupture time(TBUT)before and 1 month,3 months,and 6 months after surgery,as well as the incidence of postoperative complications and recurrence rate at 6 months after surgery were recorded.Results The clinical efficacy of the experimental group patients after treatment was higher than that of the control group,with significantly shorter postoperative conjunctival flap healing time and corneal epithelial repair time compared to the control group,the TBUT time was significantly longer than that of the control group at 1 month,3 months,and 6 months after surgery(P<0.05).There was no significant difference in the incidence and recurrence rates of postoperative complications between the two groups(P>0.05).Conclusion The combination of pterygium resection and autologous corneal limbal stem cell transplantation has good therapeutic effects and safety in the treatment of primary pterygium,which can reduce the postoperative recurrence rate without increasing the incidence of postoperative complications.