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术前翼下丝裂霉素 C 注射与角膜缘结膜自体移植预防翼状胬肉复发的比较。

Preoperative subpterygial mitomycin C injection versus limbal conjunctival autograft transplantation for prevention of pterygium recurrence.

机构信息

Department of Ophthalmology, Menoufia Faculty of Medicine, Shebin El Kom, Egypt.

出版信息

J Ocul Pharmacol Ther. 2011 Oct;27(5):481-5. doi: 10.1089/jop.2011.0022. Epub 2011 Oct 12.

Abstract

PURPOSE

To evaluate postoperative outcome and recurrence rate after primary pterygium excision using preoperative Mitomycin C (MMC) injection versus limbal conjunctival autograft transplantation (LCAT).

METHODS

Ninety-one eyes with primary pterygium were divided into 2 groups. Group A eyes (included 48 eyes) were operated upon with pterygium excision 1 month after subpterygial injection of MMC 0.015%. Group B eyes (included 43 eyes) were operated upon with pterygium excision followed by LCAT technique. Pterygium regrowth over the cornea for 1 mm or more was considered as a recurrence.

RESULTS

The follow-up period was 24 months. In group A, reported recurrence was found in 2 (4.2%) eyes with a complication rate of 16.80%. While in group B, recurrence was reported in 4 (9.3%) eyes with a complication rate of 11.63%. No serious postoperative complications were reported. There was no statistically significant difference between the 2 groups regarding the recurrence rate as well as the complication rate.

CONCLUSION

Both techniques used in the current study proved to be effective in reducing the recurrence rate after excision of primary nasal pterygium with minimal postoperative complications. Preoperative MMC injection was technically easier, with shorter operative and preservation of healthy conjunctiva. However, LCAT is a one-stage procedure and independent from adjunctive pharmacological or radiation therapies with their hazards.

摘要

目的

评估原发性翼状胬肉切除术后使用丝裂霉素 C(MMC)术前注射与角膜缘结膜自体移植(LCAT)的术后结果和复发率。

方法

91 只原发性翼状胬肉的眼睛分为 2 组。A 组(包括 48 只眼)在翼状胬肉下注射 0.015%MMC 1 个月后行翼状胬肉切除术。B 组(包括 43 只眼)行翼状胬肉切除术,随后行 LCAT 技术。角膜上超过 1 毫米的翼状胬肉再生被认为是复发。

结果

随访时间为 24 个月。在 A 组中,2 只(4.2%)眼报告复发,并发症发生率为 16.80%。而在 B 组中,4 只(9.3%)眼报告复发,并发症发生率为 11.63%。没有严重的术后并发症报告。在复发率和并发症率方面,两组之间没有统计学上的显著差异。

结论

本研究中使用的两种技术都能有效降低原发性鼻侧翼状胬肉切除术后的复发率,且术后并发症较少。术前 MMC 注射技术上更容易,手术时间更短,并且可以保留健康的结膜。然而,LCAT 是一种一步法手术,独立于辅助药物或放射治疗及其危害。

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