翼状胬肉切除联合角膜缘干细胞移植术治疗翼状胬肉的临床效果探讨

Clinical Effect of Pterygium Excision Combined with Limbal Stem Cell Transplantation in Treatment of Pterygium

目的探讨翼状胬肉切除联合角膜缘干细胞移植(Corneal Limbal Stem Cell Transplantation,CAT)术治疗翼状胬肉的临床效果。方法随机选取2022年12月—2023年10月新疆伊宁市农四师医院收治的60例翼状胬肉患者作为研究对象,采用随机数表法分为两组。对照组(30例)行翼状胬肉切除+自体结膜瓣缘干细胞移植术(Autologous Conjunctival Flap Stem Cell Transplantation,LCAT)处理,观察组(30例)行翼状胬肉切除+CAT术处理。对比两组的泪膜功能[泪膜破裂时间(Break-up Time,BUT)、泪液分泌试验(Schirmer Test,SIT)]、视力水平[裸眼视力(Naked Vision,UCVA)、角膜屈光度]以及术后并发症发生状况。结果术后3个月,两组的BUT与SIT泪膜功能指标均高于术前,但组间对比,差异无统计学意义(P均>0.05)。术后3个月,两组UCVA值高于术前,角膜屈光度小于术前,但组间对比,差异无统计学意义(P均>0.05)。观察组与对照组术后并发症发生率对比(10.00%vs 6.67%),差异无统计学意义(P>0.05)。结论翼状胬肉切除+CAT术式用于翼状胬肉患者的处理,其安全性、视力及泪膜功能改善效果与翼状胬肉切除+LCAT术式相当。

Objective To investigate the clinical effect of pterygium excision combined with corneal limbal stem cell transplantation(CAT)in treatment of pterygium.Methods A total of 60 patients with pterygium treated in Yining Agricultural Fourth Division Hospital Xinjiang Uygur Autonomous Region from December 2022 to October 2023 were randomly selected as the study objects and divided into two groups by random number table method.The control group(30 cases)underwent pterygium excision plus autconjunctival flap stem cell transplantation(LCAT),and the observation group(30 cases)underwent pterygium excision plus CAT.The function of tear film[break up time(BUT),schirmer test(SIT)],visual acuity level[naked vision(UCVA),corneal diopter]and postoperative complications were compared between the two groups.Results Three months after surgery,the tear film function indexes of BUT and SIT in both groups were higher than those before surgery,but there was no statistical significance between two groups(both P>0.05).At 3 months after operation,UCVA value was higher and corneal refraction was lower in both groups than before operation,but there was no statistical significance between the two groups(both P>0.05).There was no significant difference in the incidence of postoperative complications between the observation group and the control group(10.00%vs 6.67%)(P>0.05).Conclusion Pterygium excision plus CAT for the management of pterygium patients,the safety,visual acuity and tear film function improvement effect is similar to pterygium excision plus LCAT.