摘要
目的:评价不同手术方法治疗翼状胬肉的疗效及对泪膜稳定性的影响。方法:选取翼状胬肉患者90例90眼随机分为三组,各30例30眼,A组为单纯翼状胬肉切除,B组为翼状胬肉切除,术中应用0.2g/L丝裂霉素C,C组为翼状胬肉切除联合角膜缘干细胞移植,比较各组间术前、术后Shirmer试验(Shirmer I test,S I t)和泪膜破裂时间(tear break-up time,BUT),角结膜荧光素染色(conjunctiva fluorescein staining,CFS),眼表疾病指数(ocular surface disease index,OSDI)的变化,及术后复发率,评估手术疗效和对泪膜功能的影响。结果:术后1mo,A组BUT较术前无显著差异;B组和C组较术前的变化有显著差异(P<0.05),但两组之间差异无统计学意义;A组,B组CFS和OSDI均与C组存在显著性差异(P<0.05);但各项指标术后3mo和术前比较差异无统计学意义;术后1,3mo S I t和术前比较差异均无统计学意义;经比较A组与B、C两组复发率存在显著差异(P<0.05),B组与C组存在差异,但无统计学意义。结论:翼状胬肉切除联合角膜缘干细胞移植是目前治疗翼状胬肉的较理想手术方式,可使患者泪膜功能得到一定程度的改善。
AIM：To compare the therapeutic effects of different surgical methods of treating patients with pterygium and to observe tear film stability.
METHODS：A total of 90 pterygium patients （ 90 eyes ） were randomly divided into three groups, each 30 cases （30 eyes ）. The eyes in group A were treated with pterygium excision surgery; the eyes in group B were treated with 0.2g/L mitomycin-C and pterygium excision surgery intraoperatively; and the eyes in group C were treated with pterygium excision combined with self -corneal limbal stem cell transplantation.Data including Schirmer Ⅰ test （ SⅠt ） , tear break-up time （ BUT ） , conjunctiva fluorescein staining（ CFS） , and ocular surface disease index （ OSDI ） were recorded preoperatively and postoperatively to evaluate the clinical efficacy of surgery and the effects of tear function changes.
RESULTS：There were no significant differences in BUT in group A before the operation and one month after operation.Group B and C showed significant difference before and after operation, but differences were not statistically significant （ all P〈0.05 ）; There were no statistically significant differences in all the parameters before the operation and 3 months after operation.The indexes of CFS and OSDI at postoperative 1 month and 3 months in three groups were significantly different with those before the surgery （P〈0.05）;the indexes of BUT, SⅠt, CFS and OSDI at postoperative 1 months in three groups were statistically significant different when compared with preoperation.The significant differences were identified by comparing the recurrence rate between group A and group B and between group A and group C （ P〈0.05）. There was no statistically significant difference in recurrence rate between group B and group C （P〉0.05）.CONCLUSION： Pterygium excision combined with self-corneal limbal stem cell transplantation is an ideal surgical method in treating pterygium, and can partly restore the tear functions into normal state in patients with pterygium.
出处
《国际眼科杂志》
CAS
2013年第12期2535-2537,共3页
International Eye Science
关键词
翼状胬肉
角膜缘干细胞
移植
泪膜功能
pterygium
corneal limbal stem cell
transplantation
tear film function
