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迷你型简易性角膜缘上皮移植与翼状胬肉切除术后纤维蛋白胶固定结膜自体移植的随机对照试验。

Mini-Simple Limbal Epithelial Transplantation Versus Conjunctival Autograft Fixation With Fibrin Glue After Pterygium Excision: A Randomized Controlled Trial.

机构信息

Department of Ophthalmology, Armed Forces Medical College, Pune, India.

Department of Preventive and Social Medicine, Armed Forces Medical College, Pune, India.

出版信息

Cornea. 2019 Nov;38(11):1345-1350. doi: 10.1097/ICO.0000000000002007.

DOI:10.1097/ICO.0000000000002007
PMID:31436643
Abstract

PURPOSE

To compare the outcomes between mini-simple limbal epithelial transplantation (mini-SLET) and conjunctival autograft (CAG) fixation with fibrin glue after excision of pterygium.

METHODS

Ninety-two eyes with primary nasal pterygium were prospectively randomized into a CAG control arm and a mini-SLET study arm. Follow-up examinations were set at the first and third day, at weeks 1, 2, and 4, and at the third and sixth month after surgery. The primary outcome measure was the recurrence rate at 1, 3, and 6 months after surgery, whereas the secondary outcome measures were the intraoperative time, postoperative symptoms, and other complications.

RESULTS

Eighty-two eyes completed the 6-month follow-up interval. Of the 42 eyes that underwent CAG, 4 (9.5%) exhibited recurrences, whereas only 1 of the 40 eyes (2.5%) treated with mini-SLET had recurrence (P = 0.358). The time taken for surgery in the study group (21.4 minutes) was greater as compared to the control group (15.1 minutes) (P < 0.001). The postoperative median symptom (foreign body sensation, lacrimation, pain, and irritation) score in the CAG group was significantly more for all symptoms on day 1 and day 3; however, on day 7, it was significantly more for pain and irritation only. Except dellen formation (1 in each group), both groups exhibited different other complications, although less in the study group.

CONCLUSIONS

The study group exhibited a positive trend of less recurrence with reduced postoperative symptoms and other complications. More similar studies are required in future to validate the results.

摘要

目的

比较翼状胬肉切除术后使用迷你简易性角结膜缘上皮移植术(mini-SLET)和纤维蛋白胶固定结膜自体移植术(CAG)的效果。

方法

92 例原发性鼻侧翼状胬肉患者前瞻性随机分为 CAG 对照组和 mini-SLET 实验组。随访检查分别在术后第 1、3 天,第 1、2、4 周和第 3、6 个月进行。主要观察指标为术后 1、3、6 个月的复发率,次要观察指标为术中时间、术后症状和其他并发症。

结果

82 例患者完成了 6 个月的随访。在接受 CAG 的 42 例眼中,有 4 例(9.5%)出现复发,而在接受 mini-SLET 治疗的 40 例眼中,只有 1 例(2.5%)复发(P = 0.358)。实验组(21.4 分钟)的手术时间明显长于对照组(15.1 分钟)(P < 0.001)。术后第 1 天和第 3 天,CAG 组的中位症状(异物感、流泪、疼痛和刺激)评分在所有症状中均显著更高;然而,在术后第 7 天,仅疼痛和刺激症状评分显著更高。除了出现水疱(每组 1 例)外,两组均出现了不同的其他并发症,但实验组的并发症较少。

结论

实验组的复发率较低,术后症状和其他并发症也较少,但还需要进一步的研究来验证结果。

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