Prabhakar Srinivasapuram Krishnachary
J.S.S. Medical College & Hospital, M.G. Road, Mysore 570004, India.
Saudi J Ophthalmol. 2014 Oct;28(4):262-7. doi: 10.1016/j.sjopt.2014.03.006. Epub 2014 Mar 21.
Primary pterygium is a fibrovascular proliferation over the nasal cornea, probably resulting from the limbal stem cell deficiency. Intraoperative mitomycin-C application seems to associate with reduced recurrences, however produced ocular surface problems and vision threatening complications. The present clinical study investigated the safety profile of autologous limbal conjunctival transplantation in terms of recurrence rate, as the main outcome measure and complications as the secondary outcome.
The present study was randomised, interventional and prospective clinical study conducted from a tertiary Hospital. Pterygium excision was performed with limbal conjunctival autograft availed from the affected eye. Secondary pterygia resulting from inflammation, trauma and other diseases were excluded. Patients were followed up for 18 months for recurrence and other complications. Microsoft Office Excel 2007 was used for statistical analysis.
A total of 71 eyes of sixty-eight patients with primary pterygia included between November 2007 and October 2010. The study recruited 35 (51%) males and 33 (49%) females with mean age of 36.9 with ±12.82 years standard deviation (mean, SD) ranging from 19 to 75 years. Age grouped by range intervals categorised into six groups. Pterygium was diagnosed in 32 (45%) right eyes and 39 (55%) left eyes. There were 65 (91.55%) nasal and 4 (5.63%) temporal pterygium and no case of double head pterygia found. Average horizontal extension of the pterygium measured was 1.67 mm (±4.23) from the apex to the corneal limbus. Graft oedema in 1 (0.71%) patient, graft bleed in 2 (1.42%) cases and 1 (0.72%) case of granuloma observed. No recurrences encountered during 18 months follow up.
Pterygium occurred predominantly in the younger population group 36.9 mm (±12.82) probably due to the increased outdoor activity with high exposure to sunlight and dusty atmosphere. Absence of recurrences was probably attributable to the smaller pterygium size of 1.67 mm (±4.23), use of the autologous limbal conjunctival graft and treatable intra and post operative complications successfully.
原发性翼状胬肉是鼻侧角膜上的纤维血管增生，可能源于角膜缘干细胞缺乏。术中应用丝裂霉素-C似乎能降低复发率，但会引发眼表问题和威胁视力的并发症。本临床研究以复发率作为主要观察指标，并发症作为次要观察指标，探讨自体角膜缘结膜移植的安全性。
本研究是在一家三级医院进行的随机、干预性前瞻性临床研究。采用患眼的角膜缘结膜自体移植进行翼状胬肉切除。排除由炎症、外伤和其他疾病引起的继发性翼状胬肉。对患者进行18个月的随访，观察复发情况及其他并发症。使用Microsoft Office Excel 2007进行统计分析。
2007年11月至2010年10月期间，共纳入68例原发性翼状胬肉患者的71只眼。研究招募了35名（51%）男性和33名（49%）女性，平均年龄为36.9岁，标准差为±12.82岁，年龄范围为19至75岁。按年龄区间分组分为六组。翼状胬肉诊断于32只（45%）右眼和39只（55%）左眼。有65只（91.55%）鼻侧翼状胬肉和4只（5.63%）颞侧翼状胬肉，未发现双头翼状胬肉病例。测量的翼状胬肉从顶端到角膜缘的平均水平延伸为1.67毫米（±4.23）。1例（0.71%）患者出现移植片水肿，2例（1.42%）出现移植片出血，观察到1例（0.72%）肉芽肿。在18个月的随访中未发现复发。
翼状胬肉主要发生在平均年龄为36.9岁（±12.82）的较年轻人群中，可能是由于户外活动增加，暴露于阳光和多尘环境的机会增多。未出现复发可能归因于翼状胬肉较小，大小为1.67毫米（±4.23），使用自体角膜缘结膜移植以及成功治疗术中及术后并发症。
