Kim Yong Joon, Yoo Seung Hoon, Chung Jin Kwon
Department of Ophthalmology, Soonchunhyang University College of Medicine, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
Invest Ophthalmol Vis Sci. 2014 Nov 18;55(12):7925-33. doi: 10.1167/iovs.14-15288.
We evaluated the angiographic features of the affected limbus in patients with pterygia and assessed limbal reconstruction outcomes after limbal-conjunctival autograft (LCA) transplantation in terms of vascular remodeling.
We studied prospectively 31 eyes of 31 patients who underwent pterygium excision and LCA transplantation; 28 eyes of 28 normal participants served as controls. Anterior segment indocyanine green angiography (ICGA) was performed for each participant preoperatively and at 1 week, and 1 and 3 months postoperatively. The perioperative angiographic features of the pterygium were compared to those in normal eyes. The structural changes of the marginal corneal vascular arcades (MCAs) and LCA were quantitatively assessed postoperatively in terms of vascular density and lacunarity.
Deteriorated MCAs that extended beyond the pterygium head were observed in the pterygium group. The pterygium had a dual blood supply from the conjunctival and episcleral circulations. In terms of limbal reconstruction, the engorged reperfusion vessels arose from the adjacent episcleral vessels along the limbus at 1 week postoperatively. The reconstructed MCAs had begun to appear at 1 month postoperatively and became apparent 3 months postoperatively in 26 (83.9%) of 31 eyes of the pterygium group, resulting in a successful clinical outcome. Higher vascular density and lower lacunarity were measured in the limbus and the graft at 3 months than at 1 month (P < 0.001 for all), which indicated fine reorganization of the reconstructed vessels.
The pterygium had a dual blood supply, and the remodeling of the affected limbus and LCA continued up to 3 months postoperatively.
我们评估了翼状胬肉患者患侧角膜缘的血管造影特征，并从血管重塑的角度评估了自体角膜缘-结膜移植（LCA）术后角膜缘重建的效果。
我们前瞻性地研究了31例行翼状胬肉切除及LCA移植患者的31只眼；28名正常受试者的28只眼作为对照。对每位受试者在术前、术后1周、1个月和3个月进行眼前节吲哚菁绿血管造影（ICGA）。将翼状胬肉的围手术期血管造影特征与正常眼的进行比较。术后从血管密度和间隙度方面对周边角膜血管弓（MCA）和LCA的结构变化进行定量评估。
在翼状胬肉组中观察到MCA恶化，其范围超出了翼状胬肉头部。翼状胬肉有来自结膜和巩膜上循环的双重血液供应。在角膜缘重建方面，术后1周时充血的再灌注血管从邻近的巩膜上血管沿角膜缘发出。重建的MCA在术后1个月开始出现，术后3个月时在翼状胬肉组31只眼中的26只（83.9%）变得明显，从而获得了成功的临床结果。术后3个月时角膜缘和移植物中的血管密度高于1个月时，间隙度低于1个月时（所有比较P<0.001），这表明重建血管发生了良好的重新组织。
翼状胬肉有双重血液供应，患侧角膜缘和LCA的重塑在术后持续至3个月。
