Kawano Hiroki, Kawano Koji, Sakamoto Taiji
Department of Ophthalmology, Kagoshima University Faculty of Medicine, Kagoshima, Japan.
Oman J Ophthalmol. 2011 Sep;4(3):120-4. doi: 10.4103/0974-620X.91267.
Inferior limbal-conjunctival autograft transplantation has been described as a safe and effective treatment for primary pterygium. However, despite its multiple advantages, routine performance of this technique is difficult because the inferior conjunctiva is often too small to provide enough autograft material. To resolve this issue, we modified a technique, inferior separate limbal-conjunctival autograft transplantation, and evaluated its efficacy and safety
A total of 50 eyes of 47 patients were retrospectively studied. Our surgery consisted of a thorough pterygium excision followed by 0.02% mitomycin C application. Next, we performed inferior conjunctival autografting, in which limbal and bulbar conjunctival autografts were independently harvested and secured to the denuded limbus and the most posterior conjunctival defect at the pterygium excision site to ensure stem-cell restoration and deep fornix reconstruction, respectively; the bare sclera between the two grafts was exposed. The outcome was assessed with a three-point grading scale at the patient's last visit.
The success and recurrence rates were 96.0% (48 of 50) and 0%, respectively, assessed at follow-ups occurring at a mean of 19.2 ± 5.6 months after surgery. Only minimal complications were encountered.
A combination of inferior separate limbal-conjunctival autograft transplantation with intraoperative 0.02% mitomycin C application is a safe and effective technique enabling the routine use of under-sized autografts harvested from the inferior conjunctiva after thorough pterygium excision.
下睑缘-结膜自体移植术已被描述为治疗原发性翼状胬肉的一种安全有效的方法。然而，尽管该技术有诸多优点，但由于下结膜通常过小，无法提供足够的自体移植材料，因此常规实施该技术存在困难。为解决这一问题，我们改良了一种技术，即下睑缘-结膜分离自体移植术，并评估了其疗效和安全性。
对47例患者的50只眼进行回顾性研究。我们的手术包括彻底切除翼状胬肉，然后应用0.02%的丝裂霉素C。接下来，我们进行下结膜自体移植，分别独立采集角膜缘和球结膜自体移植物，并将其固定于翼状胬肉切除部位裸露的角膜缘和最靠后的结膜缺损处，以分别确保干细胞修复和重建深部穹窿；两块移植物之间的裸露巩膜暴露在外。在患者最后一次就诊时，采用三分制分级量表评估手术结果。
在术后平均19.2±5.6个月的随访中，成功率和复发率分别为96.0%（50只眼中的48只）和0%。仅出现了轻微并发症。
下睑缘-结膜分离自体移植术联合术中应用0.02%丝裂霉素C是一种安全有效的技术，能够在彻底切除翼状胬肉后常规使用从下结膜获取的尺寸较小的自体移植物。
