Chen Qi, Li Yun, Xu Fan, Yan Yumei, Lu Kewei, Cui Ling, Li Min
Department of Ophthalmology, People's Hospital of Guangxi Zhuang Autonomous Region , Nanning, Guangxi , People's Republic of China and.
Curr Eye Res. 2015;40(8):786-91. doi: 10.3109/02713683.2014.961612. Epub 2014 Sep 26.
To determine the postoperative symptom by using inferior conjunctival autografting (ICA) rather than superior conjunctival autografting (SCA) after excision of pterygium.
This prospective randomized control study evaluated 80 eyes of 80 consecutive patients undergoing primary pterygium surgery. Patients in each subgroup were then randomized into the ICA (n = 40) or SCA (n = 40) group. All patients were asked to return for follow up on days 1, 2, 3, 5, 7, and 14 then at months 1, 3, 6, and 12 postoperatively. Outcome measures were postoperative patient discomfort, corneal epithelial healing time, complications and recurrence rate.
Fluorescein staining revealed complete corneal epithelial healing time was 3.1 ± 0.5 d (range 2-4) in the ICA group and 3.3 ± 0.6 d (range 2-4) in the SCA group (p = 0.11). Pain scores were significantly less in the ICA group than the SCA group on follow-up days 3 and 5 (p < 0.05). Postoperative foreign body sensation scores on follow-up days 5 and 7 were significantly lower in the ICA group than the SCA group (p < 0.05). Epiphora scores were significantly less in the ICA group than the SCA group on follow-up days 3, 5, and 7 (p < 0.05). No statistically significant differences between two groups were found for the overall (conjunctival and corneal) recurrence rates (5% versus 7.5%, p = 0.64). No serious complications were encountered.
Pterygium excision with ICA led to less postoperative discomfort for patients with primary pterygium.
确定在翼状胬肉切除术后使用下结膜自体移植（ICA）而非上结膜自体移植（SCA）的术后症状。
这项前瞻性随机对照研究评估了80例连续接受原发性翼状胬肉手术患者的80只眼睛。然后将每个亚组的患者随机分为ICA组（n = 40）或SCA组（n = 40）。所有患者被要求在术后第1、2、3、5、7和14天以及术后1、3、6和12个月返回进行随访。观察指标为术后患者不适、角膜上皮愈合时间、并发症及复发率。
荧光素染色显示，ICA组角膜上皮完全愈合时间为3.1±0.5天（范围2 - 4天），SCA组为3.3±0.6天（范围2 - 4天）（p = 0.11）。在随访第3天和第5天，ICA组的疼痛评分显著低于SCA组（p < 0.05）。在随访第5天和第7天，ICA组的术后异物感评分显著低于SCA组（p < 0.05）。在随访第3、5和7天，ICA组的溢泪评分显著低于SCA组（p < 0.05）。两组的总体（结膜和角膜）复发率无统计学显著差异（5%对7.5%，p = 0.64）。未遇到严重并发症。
原发性翼状胬肉患者采用ICA切除术后不适较少。
