Kodavoor Shreesha Kumar, Ramamurthy Dandapani, Tiwari Nitin Narendra, Ramamurthy Shreyas
Department of Cornea and Refractive Services, The Eye Foundation, Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India.
Department of Cornea and Refractive Services, The Eye Foundation, Coimbatore, Tamil Nadu, India.
Indian J Ophthalmol. 2017 Aug;65(8):700-704. doi: 10.4103/ijo.IJO_284_17.
The aim of this study is to describe a modified technique of vertically split-conjunctival autograft (CAG) for primary double-head pterygium and evaluate its postoperative outcome.
In this retrospective, noncomparative, interventional case series, 87 eyes of 87 patients of double-head pterygium from June 2009 to June 2015 were included. They underwent vertical split CAG. A limbus-limbus orientation was not strictly maintained. Primary outcome measure was recurrence rate. Other outcome measures studied were graft retraction, Tenon's granuloma, dellen, and so on.
Mean age was 54.54 ± 11.51 years; M:F was 41:46. Mean follow-up was 17.28 ± 10.28 months. The only significant complication was recurrence rate of 3.45% (3 eyes out of 87). Other most common secondary outcome was graft edema, 42.52% (37 eyes out of 87) which resolved without any intervention. Other outcomes such as graft retraction (31.03%), dellen (1.15%), Tenon's granuloma (3.45%), and subconjunctival hemorrhage (36.78%) were recorded.
Modified vertical split CAG without maintaining limbus-limbus orientation, just large enough to cover the bare scleral defect, appears to be a successful technique with lower recurrence rate in treating double-head pterygium.
本研究旨在描述一种改良的垂直劈开结膜自体移植术（CAG）用于原发性双头翼状胬肉，并评估其术后效果。
在这个回顾性、非对照、干预性病例系列中，纳入了2009年6月至2015年6月期间87例双头翼状胬肉患者的87只眼。他们接受了垂直劈开CAG手术。未严格保持角膜缘至角膜缘的方向。主要结局指标是复发率。研究的其他结局指标包括移植片回缩、Tenon氏肉芽肿、角膜小凹等。
平均年龄为54.54±11.51岁；男:女为41:46。平均随访时间为17.28±10.28个月。唯一显著的并发症是复发率为3.45%（87只眼中有3只眼）。其他最常见的次要结局是移植片水肿，为42.52%（87只眼中有37只眼），无需任何干预即可消退。还记录了其他结局，如移植片回缩（31.03%）、角膜小凹（1.15%）、Tenon氏肉芽肿（3.45%）和结膜下出血（36.78%）。
改良的垂直劈开CAG术，不保持角膜缘至角膜缘的方向，仅足够大以覆盖裸露的巩膜缺损，似乎是一种治疗双头翼状胬肉复发率较低的成功技术。
