Yang Yangfan, Pi Minshi, Xu Fasong
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, 510060, China.
Department of Ophthalmology, Zhongshan Hospital,Xiamen University, Xiamen 361004, China.
Eye Sci. 2013 Jun;28(2):73-8.
To compare the long-term efficacy of a corneal limbal conjunctival autograft combined with pterygium excision in the treatment of primary pterygium.
This random control study included 63 patients (63 eyes) with primary pterygium. These were randomly divided into a group with corneal limbal conjunctival autograft combined with pterygium excision (group A) and a group with pterygium excision with exposed sclera (group B) and subjected to long-term follow up. The surgical outcomes were classified and evaluated (grade I-IV). Several indexes were analyzed, including ocular surface irritation symptom, tear film stability, surgical complication, and recurrence rate.
The follow up ranged from 24 to 38 months, (26.9+/-3.4) months on average. No recurrence was noted at 6 weeks postoperatively. At 6 months postoperatively, the recurrence rate of pterygium was 5.2% in group A and 8.0% in group B. At 1 year postoperatively, the recurrence rate in group A was 10.5% and 20.0% in group B. At the end of follow up, the recurrence rates were 13.1% in group A and 24.0% in group B. No statistical significance was found between two groups regarding the recurrence rates at each time point (P>0.05). After the follow up (> 2 years), the severity of ocular surface conditions was significantly milder in patients in group A than in group B (P<0.01). No statistically significant differences were noted between the two groups at 6 weeks, 6 months, and 1 year after surgery. No statistically significant differences were observed between the two groups regarding postoperative tear film break-up time. Fewer postoperative complications and milder ocular surface irritation symptoms occurred in patients in group A.
Corneal limbal conjunctival autograft combined with pterygium excision yields sound long-term efficacy and a low recurrence rate and induces only mild damage on the ocular surface when used as a treatment for pterygium.
比较角膜缘结膜自体移植联合翼状胬肉切除术治疗原发性翼状胬肉的长期疗效。
本随机对照研究纳入63例（63眼）原发性翼状胬肉患者。将其随机分为角膜缘结膜自体移植联合翼状胬肉切除术组（A组）和单纯翼状胬肉切除暴露巩膜组（B组），并进行长期随访。对手术结果进行分类和评估（I-IV级）。分析了包括眼表刺激症状、泪膜稳定性、手术并发症和复发率等多项指标。
随访时间为24至38个月，平均（26.9±3.4）个月。术后6周未见复发。术后6个月，A组翼状胬肉复发率为5.2%，B组为8.0%。术后1年，A组复发率为10.5%，B组为20.0%。随访结束时，A组复发率为13.1%，B组为24.0%。两组在各时间点的复发率差异无统计学意义（P>0.05）。随访超过2年后，A组患者眼表状况的严重程度明显轻于B组（P<0.01）。术后6周、6个月和1年时两组差异无统计学意义。两组术后泪膜破裂时间差异无统计学意义。A组患者术后并发症较少，眼表刺激症状较轻。
角膜缘结膜自体移植联合翼状胬肉切除术治疗翼状胬肉具有良好的长期疗效和较低的复发率，对眼表造成的损伤较小。
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