Anguria P, Ntuli S, Carmichael T
Department of Neurosciences, Division of Ophthalmology, University of the Witwatersrand Johannesburg, South Africa.
Department of Community Health, University of Limpopo Polokwane Campus, South Africa.
Afr Health Sci. 2014 Mar;14(1):72-6. doi: 10.4314/ahs.v14i1.11.
It is not clear whether demographic or pterygium characteristics or limbal stem cell deficiency determine pterygium recurrence after surgery.
To determine whether the demographic, pterygium characteristics, or limbal stem cell deficiency determine pterygium recurrence after excision.
Of 190 patients operated and followed-up for 6 months, 101 and 89 underwent free conjunctival autotransplant (CAT) or limbal conjunctival autotransplant (LCAT) respectively. The age, gender, occupation, grade of pterygium extent and degree of fleshiness, and laterality were compared between recurrent and no recurrent pterygia. Multivariate analysis was performed to determine the predictors of pterygium recurrence. Recurrence rates after surgery were compared between CAT and LCAT.
The age range of the 190 patients was 22-65 years, mean ±SD 46.4 ±10.8 years. Pterygium recurred in 52 (27.4%). Thirty-nine (75%) of 52 patients with pterygia that recurred were aged <50 years (young) vs. 72 (52%) of 138 young patients with no recurrence; odds ratio (OR) = 1.54; 95% confidence interval (95% CI) = 0.70-3.36; p = 0.28. Thirty-one (60%) of 52 participants with post-surgical recurrent pterygia had large pre-operative pterygium (grade ≥3) vs. 130 (94%) of 138 patients with large pterygia that did not recur; OR = 0.11; 95% CI = 0.04-0.28; p <0.001. Of 101 patients undergoing CAT, 29 (28.7%) experienced recurrence vs. 23 (25.8%) of 89 undergoing LCAT; p = 0.66.
Young age seems to be associated with pterygium recurrence after excision followed by conjunctival graft. Large pterygia were protective.
目前尚不清楚人口统计学特征、翼状胬肉特征或角膜缘干细胞缺乏是否会决定手术后翼状胬肉的复发情况。
确定人口统计学特征、翼状胬肉特征或角膜缘干细胞缺乏是否会决定切除术后翼状胬肉的复发情况。
在190例接受手术并随访6个月的患者中，101例和89例分别接受了游离结膜自体移植（CAT）或角膜缘结膜自体移植（LCAT）。比较复发和未复发翼状胬肉患者的年龄、性别、职业、翼状胬肉范围分级和肥厚程度以及患侧。进行多变量分析以确定翼状胬肉复发的预测因素。比较CAT和LCAT术后的复发率。
190例患者的年龄范围为22 - 65岁，平均±标准差为46.4±10.8岁。52例（27.4%）出现翼状胬肉复发。复发的52例翼状胬肉患者中，39例（75%）年龄<50岁（年轻），而138例未复发的年轻患者中有72例（52%）；比值比（OR）=1.54；95%置信区间（95%CI）=0.70 - 3.36；p = 0.28。52例术后复发翼状胬肉的参与者中，31例（60%）术前翼状胬肉较大（≥3级），而138例未复发的大翼状胬肉患者中有130例（94%）；OR = 0.11；95%CI = 0.04 - 0.28；p<0.001。101例接受CAT的患者中，29例（28.7%）复发，而89例接受LCAT的患者中有23例（25.8%）复发；p = 0.66。
年轻似乎与结膜移植切除术后翼状胬肉的复发有关。大的翼状胬肉具有保护作用。
