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[术中使用丝裂霉素C预防翼状胬肉术后复发的研究]

[Study of intraoperative mitomycin C in preventing recurrence after pterygium surgery].

作者信息

Xie Q, Mo X J, Jiang Y Q

机构信息

Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha 410011, China.

出版信息

Hunan Yi Ke Da Xue Xue Bao. 2001 Aug 28;26(4):347-9.

Abstract

OBJECTIVE

To explore the feasibility of intraoperative application of mitomycin C (MMC) in pterygium and observe the ultrastructure change of pterygium with or without intraoperative application of MMC.

METHODS

Sixty two eyes of 57 patients with primary pterygium were randomly divided into MMC group and control group, 29 patients (32 eyes) in MMC group underwent transposition with intraoperative application of MMC (0.4 mg.ml-1 for 1 minute), whereas 28 patients (30 eyes) in control group underwent transposition. The recurrence rate, complications and side effects were observed and compared between the two groups. The ultrastructure of pterygium with or without intraoperative application of MMC was studied with transmission electron microscopy. The mean follow-up was(7.6 +/- 3.4) months (1-13 minths).

RESULT

Eleven eyes of the 30 eyes in control group (36.%) showed recurrence, whereas only 2 of 32 eyes (6.3%) in MMC group showed recurrence (P < 0.005). No severe complication and side effect appeared during the follow-up. Most of fibroblasts in pterygium that underwent intraoperative MMC occurred the change of rough endoplasmic reticulum (RER) dilatation.

CONCLUSION

Intraoperative MMC appears to be an effective treatment in preventing recurrence of primary pterygium. The fibroblasts in pterygium have RER dilatation after application of MMC for 1 minute during the operation.

摘要

目的

探讨术中应用丝裂霉素C(MMC)治疗翼状胬肉的可行性,并观察术中应用MMC与未应用MMC时翼状胬肉的超微结构变化。

方法

将57例原发性翼状胬肉患者的62只眼随机分为MMC组和对照组,MMC组29例(32只眼)术中应用MMC(0.4mg/ml,1分钟)后行转位术,对照组28例(30只眼)行转位术。观察并比较两组的复发率、并发症及副作用。应用透射电子显微镜研究术中应用MMC与未应用MMC时翼状胬肉的超微结构。平均随访时间为(7.6±3.4)个月(1 - 13个月)。

结果

对照组30只眼中有11只眼(36.7%)复发,而MMC组32只眼中仅2只眼(6.3%)复发(P<0.005)。随访期间未出现严重并发症及副作用。术中应用MMC的翼状胬肉中大部分成纤维细胞出现粗面内质网(RER)扩张的变化。

结论

术中应用MMC似乎是预防原发性翼状胬肉复发的有效治疗方法。术中应用MMC 1分钟后,翼状胬肉中的成纤维细胞出现RER扩张。

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