结膜旋转自体移植联合丝裂霉素C（MMC）与游离结膜自体移植联合MMC治疗翼状胬肉的手术效果：一项随机临床试验。
Surgical outcome of conjunctival rotational autograft-mitomycin C (MMC) versus free conjunctival autograft-MMC for pterygium removal: A randomized clinical trial.
作者信息
Bamdad Shahram, Kooshki Anis Shamsi, Yasemi Masoud
机构信息
Poostchi Ophthalmology Research Center, Department of Ophthalmology, Shiraz University of Medical Sciences, Shiraz, Iran.
Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
出版信息
Electron Physician. 2017 Dec 25;9(12):5877-5884. doi: 10.19082/5877. eCollection 2017 Dec.
BACKGROUND
Pterygium is a common degenerative eye disease. Despite various surgical methods to treat pterygium, recurrence is the main complication. The main issue is finding a surgical method with the lowest recurrence.
OBJECTIVE
to compare the complications, recurrence rate and the cosmetic effects of two surgical techniques, namely conjunctival rotation autograft (CRA) and conjunctival autograft (CA), in treating pterygium.
METHODS
This randomized clinical trial was conducted at Khalili Hospital in Shiraz, Iran, from January to August 2015. Forty-five eyes from 45 patients were studied. The patients were randomly divided into two groups using the blocking method. The patients of one group were operated on by the CRA technique, while the other group was operated on by the CA method. The patients were checked for the recurrence of pterygium, and other complications at the end of the first, third, and sixth month. Finally, the data were analyzed using SPSS version 21.
RESULTS
The mean age of the patients was 42.5 years. The recurrence of pterygium was not observed in any of the patients 6 months after the surgery. Following 6 months after the operation, graft retraction occurred during the first week for one patient (4.5%) in the CA group, and five patients (21.7%) in the CRA group. The prevalence rate of graft injection among the patients of the CA and CRA groups 6 months after the operation was 9.1% and 65.2%, respectively. There was a significant correlation between injection intensity and the dissatisfaction of the patients with the operation's outcome (p=0.017).
CONCLUSION
CRA with mitomycin is considered as an effective method to reduce the recurrence of pterygium after operation. This technique can be used as an acceptable method for pterygium operation, especially for patients with insufficient conjunctiva.
CLINICAL TRIAL REGISTRATION
The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2016092119581N2.
FUNDING
The study was financially supported by Shiraz University of Medical Sciences (SUMS) (grants No. 8901).
背景
翼状胬肉是一种常见的退行性眼病。尽管有多种手术方法治疗翼状胬肉，但复发是主要并发症。主要问题是找到复发率最低的手术方法。
目的
比较结膜转位自体移植术（CRA）和结膜自体移植术（CA）这两种手术技术治疗翼状胬肉的并发症、复发率及美容效果。
方法
本随机临床试验于2015年1月至8月在伊朗设拉子的哈利利医院进行。对45例患者的45只眼进行研究。采用区组法将患者随机分为两组。一组患者采用CRA技术手术，另一组采用CA方法手术。在术后第1、3和6个月末检查患者翼状胬肉的复发情况及其他并发症。最后，使用SPSS 21版对数据进行分析。
结果
患者的平均年龄为42.5岁。术后6个月，所有患者均未观察到翼状胬肉复发。术后6个月后，CA组有1例患者（4.5%）在第一周出现移植片回缩，CRA组有5例患者（21.7%）出现移植片回缩。术后6个月，CA组和CRA组患者移植片充血的发生率分别为9.1%和65.2%。充血强度与患者对手术结果的不满意程度之间存在显著相关性（p = 0.017）。
结论
丝裂霉素辅助的CRA被认为是降低翼状胬肉术后复发的有效方法。该技术可作为翼状胬肉手术的一种可接受方法，尤其适用于结膜不足的患者。
临床试验注册
该试验在伊朗临床试验注册中心（http://www.irct.ir）注册，注册号为：IRCT2016092119581N²。
资助
本研究由设拉子医科大学（SUMS）提供资金支持（资助编号8901）。
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