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昆士兰州翼状胬肉的治疗

Treatment of pterygia in Queensland.

作者信息

Sebban A, Hirst L W

机构信息

Department of Surgery, University of Queensland, Woolloongabba, Australia.

出版信息

Aust N Z J Ophthalmol. 1991 May;19(2):123-7. doi: 10.1111/j.1442-9071.1991.tb00639.x.

Abstract

All practising ophthalmologists in Queensland completed a written survey on their current methods of treatment of pterygia. The indications for surgical removal, in decreasing order of importance, were mainly size, symptomatic complaints, cosmetic appearance and activity. Most surgeons graded pterygia into a variety of classifications. The most common form of treatment for primary pterygia was simple excision plus mobilisation of conjunctiva and suturing conjunctival free edges together followed by bare sclera technique, and simple excision plus thiotepa drops. For recurrent pterygia simple excision plus beta-irradiation was the most common form of treatment, followed by simple excision plus thiotepa drops and simple excision plus mobilisation of conjunctiva and suturing conjunctival free edges together. A third of the ophthalmologists electively avoid cautery use during pterygium surgery, while almost a quarter of the ophthalmologists attempt to polish the corneal and limbal region. When beta-radiation or Thiotepa is used there is a general consensus on the dosage for each of these. Seventeen per cent of ophthalmologists said they had not encountered any complications after pterygium surgery with the remainder quoting corneoscleral necrosis from beta-radiation and Tenon's granuloma as the most common complications. It would appear that there is no consensus on the best way to treat pterygia in Queensland, which probably reflects the lack of scientific proof for one method being superior to another.

摘要

昆士兰州所有执业眼科医生都完成了一项关于他们目前翼状胬肉治疗方法的书面调查。手术切除的指征,按重要性递减顺序排列,主要是大小、症状性主诉、外观和活动情况。大多数外科医生将翼状胬肉分为多种类别。原发性翼状胬肉最常见的治疗方式是单纯切除加结膜松动并将结膜游离边缘缝合在一起,然后采用裸巩膜技术,以及单纯切除加噻替哌滴眼液。对于复发性翼状胬肉,单纯切除加β射线照射是最常见的治疗方式,其次是单纯切除加噻替哌滴眼液以及单纯切除加结膜松动并将结膜游离边缘缝合在一起。三分之一的眼科医生在翼状胬肉手术中选择性地避免使用烧灼术,而几乎四分之一的眼科医生试图对角膜和角膜缘区域进行打磨。当使用β射线或噻替哌时,对于每种药物的剂量有普遍共识。17%的眼科医生表示他们在翼状胬肉手术后未遇到任何并发症,其余医生则指出β射线导致的角膜巩膜坏死和眼球筋膜肉芽肿是最常见的并发症。昆士兰州似乎对于治疗翼状胬肉的最佳方法没有达成共识,这可能反映出缺乏一种方法优于另一种方法的科学依据。

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