Wanzeler Ana Cláudia Viana, Duarte Bruna, de Andrade Vitor Duarte Moron, Alves Monica
Department of Ophthalmology, University of Campinas, Campinas, SP, Brazil.
Pontific Catholic University of Campinas, Campinas, SP, Brazil.
Clin Ophthalmol. 2018 May 3;12:833-837. doi: 10.2147/OPTH.S155631. eCollection 2018.
Pterygium is a fibrovascular condition of the ocular surface that can cause a broad range of irritative and visual symptoms. Controversy exists regarding pterygium mechanisms, management, surgical techniques, adjuvant approaches and impact on patients' quality of life. We performed a retrospective survey focused on the impact of pterygium-related symptoms before surgery and patients' satisfaction after excision surgery followed by conjunctival autograft transplantation with fibrin glue, based on patients' subjective reporting.
All patients underwent surgery consisting of the extensive removal of the pterygium fibrovascular tissue, followed by autologous conjunctival graft fixed with fibrin glue to cover the bare scleral area. A total of 500 patients were contacted by phone call and invited to participate in the study answering a brief two-question survey. First, to grade overall intensity of symptoms related to pterygium before surgical intervention, such as pain, irritation, tearing, red eye, photophobia, burning and foreign body sensation, using a scale from 0 to 10 (0 asymptomatic and 10 very severe symptoms). Results were categorized as mild (0-3), moderate (4-7) and severe (8-10). Then, patients were asked about their satisfaction with the surgery outcome, also using a scale from 0 to 10 (ranging from dissatisfied to fully satisfied).
Patients' mean age was 41.5±12.31 (min 18/max 83) years old and the mean of days after surgery was 1,493±552.7 (min 711/max 2,702). Symptoms were referred to as severe (70.2%), moderate (25.2%) and mild (4.6%). After surgery, most patients were fully satisfied and the mean grade was 9.6; 1% (0-3), 2.4% (4-7) and 96.6% (8-10). Women presented a higher score of symptoms compared to men (<0.01) but similar satisfaction rates.
The present study shows that pterygium greatly impacts on patients' quality of life and that excision surgery using conjunctival autograft transplantation and fibrin glue improved symptoms with high rates of satisfaction.
翼状胬肉是一种眼表的纤维血管病变，可引起多种刺激症状和视觉症状。关于翼状胬肉的发病机制、治疗、手术技术、辅助治疗方法以及对患者生活质量的影响存在争议。我们基于患者的主观报告进行了一项回顾性调查，重点关注手术前翼状胬肉相关症状的影响以及切除手术联合纤维蛋白胶结膜自体移植术后患者的满意度。
所有患者均接受手术，包括广泛切除翼状胬肉纤维血管组织，然后用纤维蛋白胶固定自体结膜移植片覆盖裸露的巩膜区域。通过电话联系了总共500名患者，邀请他们参与一项简短的两问题调查。首先，使用0至10分的量表（0分为无症状，10分为症状非常严重）对手术干预前与翼状胬肉相关的症状总体强度进行评分，如疼痛、刺激感、流泪、眼红、畏光、烧灼感和异物感。结果分为轻度（0 - 3分）、中度（4 - 7分）和重度（8 - 10分）。然后，询问患者对手术结果的满意度，同样使用0至10分的量表（从不满意到完全满意）。
患者的平均年龄为41.5±12.31岁（最小18岁/最大83岁），术后平均天数为1493±552.7天（最小711天/最大2702天）。症状被评为重度（70.2%）、中度（25.2%）和轻度（4.6%）。手术后，大多数患者完全满意，平均评分为9.6分；不满意（0 - 3分）的占1%，较不满意（4 - 7分）的占2.4%，完全满意（8 - 10分）的占96.6%。女性的症状评分高于男性（<0.01），但满意度相似。
本研究表明，翼状胬肉对患者的生活质量有很大影响，采用结膜自体移植联合纤维蛋白胶的切除手术可改善症状，满意度较高。
