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结膜旋转自体移植治疗翼状胬肉:传统结膜自体移植的替代方法

Conjunctival Rotation Autograft for Pterygium: An Alternative to Conventional Conjunctival Autografting.

作者信息

Sune Mona P, Sune Pradeep G

机构信息

From the Department of Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed University), Sawangi ,Wardha, India.

出版信息

Asia Pac J Ophthalmol (Phila). 2013 Jul-Aug;2(4):227-31. doi: 10.1097/APO.0b013e3182993f8c.

Abstract

PURPOSE

To determine the safety and efficacy of conjunctival rotation autograft (CRA) as an alternative to conventional conjunctival autograft after pterygium excision and its complications and rate of recurrence.

DESIGN

A prospective non-comparative interventional case study.

METHODS

Conjunctival rotation autograft was performed under peribulbar block in 50 eyes with primary pterygium as well as recurrent pterygium of grade 1, 2 and 3 according to a morphological grading system. Patients were followed up for 12 months for complications like graft retraction, injection, recurrence, etc.

RESULTS

A total of 55 CRAs were done in 50 eyes of 47 subjects in the study wherein grafts were attached by using the 10-0 nylon sutures in primary and recurrent pterygia. Mean follow up period was 11.67 months (Range 9-12 months). The most commonly found complications were graft injection in 16 (29.09%) cases and graft pigmentation in 5 (9.0%) cases. Injection was not associated with pterygium grade and was found to be statistically insignificant (P = 0.27). Recurrence was found only in 1 (1.8%) case in grade T3 recurrent pterygium.

CONCLUSIONS

Conjunctival rotation autograft appears to be a successful and safe alternative to conjunctival autograft, with a relatively low rate of pterygium recurrence in this uncontrolled series. We advocate the use of CRA for cases of pterygium in which a conventional autograft is contraindicated or difficult. In addition, the procedure can be used as a primary surgical option in primary and recurrent pterygia.

摘要

目的

确定结膜旋转自体移植术(CRA)作为翼状胬肉切除术后传统结膜自体移植术的替代方法的安全性和有效性,以及其并发症和复发率。

设计

一项前瞻性非对照干预性病例研究。

方法

根据形态学分级系统,对50只患有原发性翼状胬肉以及1、2、3级复发性翼状胬肉的眼睛在球周阻滞麻醉下进行结膜旋转自体移植术。对患者进行12个月的随访,观察移植片回缩、充血、复发等并发症。

结果

本研究中47名受试者的50只眼睛共进行了55次结膜旋转自体移植术,其中原发性和复发性翼状胬肉均使用10-0尼龙缝线固定移植片。平均随访期为11.67个月(范围9-12个月)。最常见的并发症是16例(29.09%)移植片充血和5例(9.0%)移植片色素沉着。充血与翼状胬肉分级无关,且在统计学上无显著意义(P = 0.27)。仅在1例T3级复发性翼状胬肉中发现复发(1.8%)。

结论

在这个非对照系列中,结膜旋转自体移植术似乎是结膜自体移植术的一种成功且安全的替代方法,翼状胬肉复发率相对较低。我们提倡在传统自体移植术禁忌或困难的翼状胬肉病例中使用结膜旋转自体移植术。此外,该手术可作为原发性和复发性翼状胬肉的主要手术选择。

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