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原发性翼状胬肉手术中翼状胬肉形态对术前结膜下注射丝裂霉素-C后复发的影响。

Effect of Pterygium Morphology on Recurrence with Preoperative Subconjunctival Injection of Mitomycin-C in Primary Pterygium Surgery.

作者信息

Khan Faisal Aziz, Niazi Shafaq Pervez Khan

机构信息

Department of Eye, Combined Military Hospital, Malir Cantt, Karachi, Pakistan.

出版信息

J Coll Physicians Surg Pak. 2019 Jul;29(7):639-643. doi: 10.29271/jcpsp.2019.07.639.

Abstract

OBJECTIVE

To investigate the effect of pterygium morphology on recurrence with preoperative subconjunctival injection of mitomycin-C in primary pterygium surgery.

STUDY DESIGN

Quasi-experimental study.

PLACE AND DURATION OF STUDY

Eye Department, Combined Military Hospital, Malir Cantt, Karachi, from February 2017 to February 2018.

METHODOLOGY

On the basis of pterygium morphology, 165 eyes of 165 patients were equally divided into three equal groups of atrophic, intermediate and fleshy pterygia. In each morphology group, length was graded into three groups using limbus, pupil margin and midiris as landmarks. All pterygia received 0.1 ml of mitomycin-C injection in a concentration of 0.15 mg/ml at 24 hours prior to undergoing a bare sclera surgical excision technique in all cases. All patients were followed up for 12 months. The recurrence rate was recorded in each morphology group. Pearson Chi-Square test was used to compare recurrence rate and morphology group. Fisher's exact test was applied to compare recurrence rate with length and age in each type of morphology.

RESULTS

Among the three morphology groups, the recurrence rate was statistically significant between fleshy and atrophic pterygia (p=0.01) and no significant association was found among other morphology comparisons. Age less than 40 years had a significant effect on recurrence in all morphology groups. Length did not affect the recurrence rate in any of morphology types.

CONCLUSION

Recurrence of primary pterygium is related to fleshiness of the pterygium and is a significant risk factor for recurrence after preoperative subconjunctival injection of mitomycin-C given at 24 hours before sclera excision.

摘要

目的

探讨原发性翼状胬肉手术中术前结膜下注射丝裂霉素C时翼状胬肉形态对复发的影响。

研究设计

半实验性研究。

研究地点及时间

2017年2月至2018年2月,卡拉奇马里尔军营联合军事医院眼科。

方法

根据翼状胬肉形态,将165例患者的165只眼平均分为萎缩型、中间型和肥厚型翼状胬肉三组。在每种形态学组中,以角膜缘、瞳孔缘和虹膜中部为标志将长度分为三组。所有翼状胬肉在采用单纯巩膜手术切除技术前24小时均接受浓度为0.15mg/ml的丝裂霉素C 0.1ml注射。所有患者随访12个月。记录每组形态学组的复发率。采用Pearson卡方检验比较复发率与形态学组。采用Fisher精确检验比较每种形态学类型的复发率与长度和年龄。

结果

在三种形态学组中,肥厚型和萎缩型翼状胬肉之间的复发率有统计学意义(P = 0.01),其他形态学比较未发现显著相关性。年龄小于40岁对所有形态学组的复发有显著影响。长度对任何一种形态学类型的复发率均无影响。

结论

原发性翼状胬肉的复发与翼状胬肉的肥厚程度有关,是术前结膜下注射丝裂霉素C(在巩膜切除前24小时给药)后复发的一个重要危险因素。

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