Ang Leonard P K, Chua Jocelyn L L, Tan Donald T H
Singapore National Eye Centre, Singapore.
Curr Opin Ophthalmol. 2007 Jul;18(4):308-13. doi: 10.1097/ICU.0b013e3281a7ecbb.
Pterygium is a common ocular disorder in many parts of the world. At present, there is a wide variety of surgical methods but very few clinical guidelines on the optimal treatment of primary or recurrent pterygium. The purpose of this review is to summarize the more recent and relevant studies on pterygium treatment.
The primary aim is to excise the pterygium and prevent its recurrence. As bare sclera excision is associated with a high recurrence rate, pterygium excision is often combined with conjunctival autograft, mitomycin C, beta-irradiation or other adjunctive therapies to reduce recurrence rates. There is currently, however, no consensus regarding the ideal treatment for the disease. Comparability between studies is also hampered by the various definitions of pterygium recurrence.
This article reviews the current concepts and techniques used for the treatment of pterygium. Conjunctival autografting and mitomycin C application are the most commonly used methods for preventing recurrences. The use of mitomycin C and beta-irradiation should be used judiciously because of the potential long-term risk of sight-threatening complications. Additional clinical trials should be performed to evaluate the relative efficacies and long-term safety of the various treatment modalities.
翼状胬肉是世界许多地区常见的眼部疾病。目前,手术方法多种多样,但关于原发性或复发性翼状胬肉最佳治疗的临床指南却很少。本综述的目的是总结关于翼状胬肉治疗的最新相关研究。
主要目标是切除翼状胬肉并防止其复发。由于单纯巩膜切除术复发率高,翼状胬肉切除术常联合结膜自体移植、丝裂霉素C、β射线照射或其他辅助治疗以降低复发率。然而,目前对于该疾病的理想治疗方法尚无共识。翼状胬肉复发的各种定义也妨碍了研究之间的可比性。
本文综述了目前用于治疗翼状胬肉的概念和技术。结膜自体移植和丝裂霉素C应用是预防复发最常用的方法。由于存在威胁视力并发症的潜在长期风险,丝裂霉素C和β射线照射的使用应谨慎。应进行更多临床试验以评估各种治疗方式的相对疗效和长期安全性。