Karadag Remzi, Sevimli Neslihan, Okumus Seydi, Ozsoy Isilay, Bayramlar Huseyin, Durucu Ela, Aksoy Umit, Rapuano Christopher J
Istanbul Medeniyet University School of Medicine, Department of Ophthalmology, Goztepe, Istanbul, Turkey.
Cornea Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.
Arq Bras Oftalmol. 2017 Nov-Dec;80(6):373-377. doi: 10.5935/0004-2749.20170091.
To compare the effects of 90° and 180° conjunctival rotational autograft (CRA) techniques used in primary pterygium surgery.
Forty-five patients were included in this retrospective study. Visual acuity (VA), corneal topography, and auto-refractometer measurements, as well as detailed biomicroscopic examinations, were performed preoperatively and postoperatively. During surgery, the pterygium tissue was excised then rotated 90° in Group 1 and180° in Group 2, after which it was sutured to the bare sclera. Pterygium recurrence was defined as corneal invasion ≥1 mm.
Group 1 consisted of 21 patients with a mean age of 45.1 ± 11.8 years, while Group 2 comprised 24 patients with a mean age of 47.9 ± 13.8 years. The pterygia in Group 1 were graded as more advanced than those in Group 2. A similar number of recurrences were observed in Group 1 (14.3%) and in Group 2 (16.7%). There was no statistically significant difference in terms of the preoperative and postoperative VA and astigmatism values between the two groups. There was a statistically significant improvement in the postoperative VA and astigmatism values in Group 1 and in the postoperative astigmatism values in Group 2. Although postoperative redness was more common in Group 1, no statistically significant difference was found between the groups.
BothCRA techniques can be successful in patients for whom it is desirable to avoid a conjunctival autograft and for patients without high cosmetic expectations.
比较原发性翼状胬肉手术中90°和180°结膜旋转自体移植（CRA）技术的效果。
本回顾性研究纳入了45例患者。术前和术后均进行视力（VA）、角膜地形图、自动验光仪测量以及详细的生物显微镜检查。手术过程中，切除翼状胬肉组织，然后在第1组中旋转90°，在第2组中旋转180°，之后将其缝合至裸露的巩膜。翼状胬肉复发定义为角膜侵犯≥1mm。
第1组有21例患者，平均年龄45.1±11.8岁，第2组有24例患者，平均年龄47.9±13.8岁。第1组的翼状胬肉分级比第2组更严重。第1组（14.3%）和第2组（16.7%）观察到的复发例数相似。两组之间术前和术后的VA及散光值无统计学显著差异。第1组术后VA和散光值以及第2组术后散光值有统计学显著改善。虽然术后眼红在第1组更常见，但两组之间未发现统计学显著差异。
对于希望避免结膜自体移植的患者以及对美容期望不高的患者，两种CRA技术都可能成功。
