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双眼翼状胬肉病例中垂直劈开结膜自体移植术采用与不采用角膜缘对角膜缘定向的比较——一项回顾性分析

Comparison of vertical split conjunctival autograft with and without limbus to limbus orientation in cases of double-head pterygium-A retrospective analysis.

作者信息

Kodavoor Shreesha K, Soundarya B, Dandapani Ramamurthy

机构信息

Department of Cornea and Refractive Services, The Eye Foundation, Coimbatore, Tamil Nadu, India.

出版信息

Indian J Ophthalmol. 2020 Apr;68(4):573-576. doi: 10.4103/ijo.IJO_1079_19.

DOI:10.4103/ijo.IJO_1079_19
PMID:32174571
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7210860/
Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b754/7210860/a0a833288cb0/IJO-68-573-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b754/7210860/9c05fe169ebd/IJO-68-573-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b754/7210860/8e56342e5ef8/IJO-68-573-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b754/7210860/2c15c1343da7/IJO-68-573-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b754/7210860/a0a833288cb0/IJO-68-573-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b754/7210860/9c05fe169ebd/IJO-68-573-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b754/7210860/8e56342e5ef8/IJO-68-573-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b754/7210860/2c15c1343da7/IJO-68-573-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b754/7210860/a0a833288cb0/IJO-68-573-g004.jpg

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本文引用的文献

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J Ophthalmol. 2018 Dec 20;2018:9341846. doi: 10.1155/2018/9341846. eCollection 2018.
2
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Indian J Ophthalmol. 2017 Aug;65(8):700-704. doi: 10.4103/ijo.IJO_284_17.
3
Double-Headed Pterygia Treated With P.E.R.F.E.C.T for PTERYGIUM.
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Cornea. 2017 Jan;36(1):98-100. doi: 10.1097/ICO.0000000000001036.
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Surgical Management of Double-Head Pterygium Using a Modified Split-Conjunctival Autograft Technique.采用改良的结膜自体移植劈裂技术治疗双头翼状胬肉的手术管理
Semin Ophthalmol. 2017;32(5):569-574. doi: 10.3109/08820538.2015.1131836. Epub 2016 May 18.
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Conjunctival Autograft Versus Amniotic Membrane Transplantation After Double Pterygium Excision: A Randomized Trial.双睑裂斑切除术后结膜自体移植与羊膜移植的随机对照试验
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