翼状胬肉逆行切除加新鲜羊膜移植的临床观察

Clinical Observation on Fresh Amniotic Membrane Transplantation for Treatment of Recurrent Pterygium

目的:观察翼状胬肉逆行切除加新鲜羊膜移植预防翼状胬肉复发的疗效。方法:沿胬肉体两侧分别剪开球结膜,钝性分离球结膜与其下的增生组织,于胬肉体部剪断已分离球结膜,并向泪阜侧掀开,将增生的胬肉组织充分暴露;再将胬肉与巩膜进行分离,于半月皱襞处剪断胬肉根部,然后逆行将胬肉头部自角膜上分离下来,将新鲜羊膜移植于巩膜裸露区。结果:50例(60只眼)翼状胬肉患者随访6～19个月,2眼复发,复发率3.3％,羊膜移植片未见免疫排斥反应或溶解吸收。结论:胬肉逆行切除加新鲜羊膜移植大大降低翼状胬肉的术后复发率。是目前治疗翼状胬向较理想的手术方法。新鲜羊膜具有取材简单,使用方便,费用低廉等优点,适合在基层医院推广使用。眼科学报 2002;18:220-221.

Purpose: To observe the effect of retrograding excision of ptergium with amniotic membrane transplantation on the prevention of pterygium relapse. Methods: Incisions of conjunctiva were made along both sides of pterygium body. The conjunctiva was then separated from the underlying pterygium tissue and cut at the side of pterygium body. It was further separated from the underlying ptergium tissues toward the caruncle so that the ptergium tissue could be exposed, which was separated from the sclera and then was excised at the site of the plicae semilunaris and separated from the cornea retrogressively. The exposed sclera was then covered by transplanted amniotic membrane. Results: After 6-19 months of follow-up, two in 60 eyes of pterygium relapsed, recurrent rate 3. 3%. No immune rejection, necrosis and graft absorption were found. Conclusion: Retrograding excision of pterygium with fresh amniotic membrane transplantation can significantly decrease the relapse of pterygium. Amniotic membrane transplantation is a reasonable method for treatment of pterygium. Fresh amniotic membrane transplantation has advantages of easily obtain, convenient usage, and lower cost, which is suitable in local hospital of our country. Eye Science 2002; 18: 220 -222.