羊膜移植术和羊膜联合角膜缘上皮移植术治疗复杂性翼状胬肉

Transplantation of amniotic membrane and amniotic membrane combined with limbal autograft for patients with complicated pterygium

目的 :比较羊膜移植术与羊膜联合自体角膜缘上皮移植术治疗各种复杂性翼状胬肉的疗效。方法 :对 42例 ( 48眼 )复发性翼状胬肉和假性胬肉并睑球粘连患者分别行羊膜移植术 ( 2 0例 ,2 2眼 )和羊膜联合自体角膜缘上皮移植术 ( 2 2例 2 6眼 ) ;术后随访 6～ 12 (平均 8.5 )个月。结果 :术后 2周 ,羊膜联合自体角膜缘上皮移植术组 ,除 2眼外角膜创面完全上皮化 ,达到无瘢痕性愈和 ;而羊膜移植术组有 8眼角膜创面未完全修复 (P <0 .0 5 )。随访 1年 ,羊膜联合自体角膜缘上皮移植术组未见无排斥反应发生和胬肉复发 ,而羊膜移植术组有 3眼出现不同程度胬肉复发。结论 :羊膜联合自体角膜缘上皮移植术较单纯羊膜移植术治疗复发性或假性翼状胬肉 ,能更有效地抑制结膜下纤维增生、重建角膜缘屏障、促进角膜创面修复 ,从而提高治疗效果 ,降低复发率。

Objective To evaluate the curative effects of amniotic membrane transplantation and amniotic membrane combined with limbal autograft on patients of complicated pterygium. Methods Forty-two cases (48 eyes) of recurrent pterygium or pseudopterygium were operated on with human amniotic membrane transplantation (20 cases 22 eyes) and amniotic membrane combined with limbal autograft (22 cases 26 eyes). All cases were followed up for 6-12 months. Results In 2 week postoperation,corneal wound recovered quickly and cured by epithelialum except two eyes in amniotic membrane combined with limbal autograft group,but 8 eyes were not cured in amniotic membrane transplantation group.There was significant difference between two groups (P<0.05). In the terms of follow-up,no rejection or recurrence were found in amniotic membrane with limbal autograft group,but 3 eyes recurred a relapse in amniotic membrane transplantation group. Conclusion Amniotic membrane combined with limbal autograft is more effective in the treatment of recurrence or pseudopterygium than amniotic membrane transplantation, and is able to inhibite fibrosis, reconstruct the ocular surface and promote the epithelial recovery,so as to improve the curative effect and decrease the recurrence.