自体角膜缘干细胞移植术对翼状胬肉患者临床疗效及并发症的影响

The Impact of Autologous Limbal Stem Cell Transplantation on the Clinical Efficacy and Complications in Patients with Pterygium

目的探究自体角膜缘干细胞移植术治疗翼状胬肉患者的临床效果。方法选择2018年5月至2022年12月在虞城县第二人民医院治疗的82例翼状胬肉患者,应用随机数表法将其分为对照组(翼状胬肉切除术)及观察组(翼状胬肉切除术联合自体角膜缘干细胞移植术)各41例,对比两组临床指标、治疗有效率、视觉质量、泪膜功能、角膜屈光状态、并发症、复发率。结果观察组角膜上皮修复时间、术后拆线时间、视力改善时间均短于对照组,差异均有统计学意义(P<0.05)。观察组治疗有效率高于对照组,差异具有统计学意义(P<0.05)。观察组角膜散光度(CAD)、调制传递函数截止频率(MTFcutoff)、斯特列尔比(SR)、泪膜动态客观散射指数(TF-OSI)均优于对照组,差异均有统计学意义(P<0.05)。观察组泪膜破裂时间(BUT)长于对照组,泪液分泌试验(SIT)大于对照组,角膜荧光素染色(FL)评分均低于对照组,差异均有统计学意义(P<0.05)。观察组裸眼视力(UCVA)、角膜水平曲度、角膜垂直曲度均优于对照组,差异均有统计学意义(P<0.05)。对照组并发症、复发率均高于观察组,差异均有统计学意义(P<0.05)。结论对翼状胬肉患者进行翼状胬肉切除术治疗基础上联合自体角膜缘干细胞移植术,疗效显著,可提升患者视觉质量,改善患者泪膜功能、角膜屈光状态,降低并发症发生率,促进患者康复。

Objective To explore the clinical effects of autologous limbal stem cell transplantation in treating patients with pterygium.Methods 82 patients with pterygium treated in The Second People’s Hospital of Yucheng County from May 2018 to December 2022 were selected and divided into a control group(pterygium excision)and an observation group(pterygium excision combined with autologous limbal stem cell transplantation)of 41 cases each using a random number table method.The clinical indicators,treatment effectiveness rate,visual quality,tear film function,corneal refractive status,complications,and recurrence rate of the two groups were compared.Results The corneal epithelial repair time,postoperative suture removal time,and visual improvement time in the observation group were all shorter than those in the control group,with statistically significant differences(P<0.05).The treatment effectiveness rate in the observation group was higher than that in the control group,with a statistically significant difference(P<0.05).The corneal astigmatism degree(CAD),modulation transfer function cutoff frequency(MTFcutoff),Strehl ratio(SR),and tear film dynamic objective scatter index(TF-OSI)in the observation group were all better than those in the control group,with statistically significant differences(P<0.05).The tear film break-up time(BUT)in the observation group was longer than that in the control group,the Schirmer’s I test(SIT)was greater than that in the control group,and the corneal fluorescein staining(FL)scores were all lower than those in the control group,with statistically significant differences(P<0.05).The uncorrected visual acuity(UCVA),corneal horizontal curvature,and corneal vertical curvature in the observation group were all better than those in the control group,with statistically significant differences(P<0.05).The complication rate and recurrence rate in the control group were both higher than those in the observation group,with statistically significant differences(P<0.05).Conclusion The combination of pterygium excision and autologous limbal stem cell transplantation in treating patients with pterygium has significant effects,can improve patient visual quality,improve patient tear film function and corneal refractive status,reduce the incidence of complications,and promote patient recovery.