Department of Ophthalmology, Chung-Ang University Hospital, Seoul, Korea.
Br J Ophthalmol. 2013 Jun;97(6):694-700. doi: 10.1136/bjophthalmol-2012-302784. Epub 2013 Mar 15.
To evaluate the efficiency of multimicroporous expanded polytetrafluoroethylene (e-PTFE) insertion in complicated multirecurrent pterygia.
A total of 62 eyes from 62 patients with a multirecurrent pterygium associated with symblepharon or motility restriction-related binocular diplopia were recruited. All eyes underwent pterygia excision followed by application of 0.033% mitomycin C, amniotic membrane transplantation and conjunctival limbal autograft. Multimicroporous e-PTFE was then inserted intraoperatively in 30 eyes between the transplanted amniotic membrane and the conjunctiva (group A), but not inserted in the other 32 eyes (group B). The main outcome measures were symblepharon formation, motility restriction, binocular diplopia, subjective score of conjunctival hyperaemia and postoperative pterygium recurrence.
In the mean follow-up period of 17.2±2.3 months, symblepharon formation, motility restriction, diplopia and conjunctival hyperaemia were significantly improved after surgery in group A patients (p=0.000, 0.000, 0.008 and 0.000, respectively). Postoperative symblepharon formation, motility restriction and conjunctival hyperaemia were significantly less in group A compared to group B (p=0.024, 0.027 and 0.000, respectively). After surgery, corneal recurrence developed in one eye (3.3%) from group A, which was significantly lower than the eight eyes (25%) from group B (p=0.027).
Multimicroporous e-PTFE insertion may provide a novel approach for treating intractable complicated multirecurrent pterygia.
评估多孔膨化聚四氟乙烯(e-PTFE)在复杂复发性翼状胬肉中的应用效果。
共纳入 62 例 62 只眼,这些眼均为复发性翼状胬肉,伴有球结膜粘连或运动受限引起的双眼复视。所有眼均接受翼状胬肉切除术,然后应用 0.033%丝裂霉素 C、羊膜移植和结膜角膜缘自体移植。30 只眼(A 组)在移植羊膜和结膜之间术中插入多孔膨化 e-PTFE,而其他 32 只眼(B 组)未插入。主要观察指标为球结膜粘连、运动受限、双眼复视、结膜充血主观评分和术后翼状胬肉复发。
平均随访 17.2±2.3 个月后,A 组患者的球结膜粘连形成、运动受限、复视和结膜充血均明显改善(p=0.000、0.000、0.008 和 0.000)。与 B 组相比,A 组术后球结膜粘连形成、运动受限和结膜充血明显减少(p=0.024、0.027 和 0.000)。A 组有 1 只眼(3.3%)术后出现角膜复发,明显低于 B 组的 8 只眼(25%)(p=0.027)。
多孔膨化 e-PTFE 插入可能为治疗难治性复杂复发性翼状胬肉提供一种新方法。