Kodavoor Shreesha K, Soundarya B, Dandapani Ramamurthy
Department of Cornea and Refractive Services, The Eye Foundation, Coimbatore, Tamil Nadu, India.
Indian J Ophthalmol. 2020 Apr;68(4):573-576. doi: 10.4103/ijo.IJO_1079_19.
The aim of this study is to compare the outcome and complications in patients who underwent double-head pterygium excision with split conjunctival autograft with and without limbus to limbus orientation.
In this retrospective, comparative study, 99 eyes with double-head pterygium which underwent split conjunctival autograft with limbus to limbus orientation (Group 1) and 93 eyes which underwent without limbus to limbus orientation (Group 2) during the period of 2011-2016 were included in this study. The primary outcome compared was the recurrence rate. Other complications were included as secondary outcomes.
Mean age in group 1 and group 2 were 46.84 +/- 10.78 years and 54.38 +/- 11.44 years respectively. M:F was 36:63 in group 1 and 45:48 in group 2 with a mean follow up of 18.30 +/- 7.48 months in group 1 and 17.04 +/- 9.98 months in group 2. Recurrence was seen in 4 cases in each of the 2 groups with the mean time of recurrence being 7 +/- 2.34 months in group 1 and 6 +/- 2.01 months in group 2. Other complications included graft edema, SCH, graft retraction, granuloma, dellen and graft loss with only graft loss being statistically significant between 2 groups.
This study provides data that recurrence rates are not different among patients who undergo split conjunctival graft with and without limbal orientation. The strict adherence to maintaining limbus to limbus orientation while managing double-headed pterygia may not be necessary in all cases, especially in those with large defects following excision.
本研究旨在比较采用带角膜缘对角膜缘定向和不带角膜缘对角膜缘定向的自体结膜瓣移植术治疗双眼翼状胬肉患者的疗效及并发症。
在这项回顾性比较研究中,纳入了2011年至2016年期间接受角膜缘对角膜缘定向自体结膜瓣移植术的99只双眼翼状胬肉眼(第1组)和未采用角膜缘对角膜缘定向的93只眼(第2组)。比较的主要结局指标是复发率。其他并发症作为次要结局指标。
第1组和第2组的平均年龄分别为46.84±10.78岁和54.38±11.44岁。第1组男女比例为36:63,第2组为45:48,第1组平均随访时间为18.30±7.48个月,第2组为17.04±9.98个月。两组各有4例复发,第1组复发的平均时间为7±2.34个月,第2组为6±2.01个月。其他并发症包括移植片水肿、巩膜瓣下积液、移植片退缩、肉芽肿、角膜缘干性角膜病变和移植片丢失,两组间仅移植片丢失具有统计学意义。
本研究提供的数据表明,采用带角膜缘和不带角膜缘定向的自体结膜移植术的患者复发率无差异。在处理双眼翼状胬肉时,并非在所有情况下都必须严格坚持角膜缘对角膜缘的定向,尤其是在切除后有大缺损的患者中。