Razmjoo Hasan, Kashfi Seyed-Abolfazl, Mirmohammadkhani Majid, Pourazizi Mohsen
Department of Ophthalmology, Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.
J Res Pharm Pract. 2020 Mar 28;9(1):10-15. doi: 10.4103/jrpp.JRPP_19_127. eCollection 2020 Jan-Mar.
To evaluate the recurrence rate and outcome of pterygium surgery with amniotic membrane transplantation (AMT) and intraoperative mitomycin C (MMC).
This prospective clinical study included patients with pterygium who were candidates for pterygium excision. After the surgical excision, intraoperative local MMC were applied in the standard protocol followed by AMT. The outcome measures were recurrence and the size change of lesion. Kaplan-Meier estimation and regression analyses were performed.
Fifty five eyes of 55 consecutive patients including 30 male (54.5%) and 25 female (45.5%) with mean age of 47.12 ± 15.95 years were operated. The mean follow-up period was 15.21 ± 2.67 months. The overall recurrence rate was 34.5% (19/55 cases). The estimated recurrence time for larger size of pterygium before surgery was short and marginally significant (17.14 ± 0.58 month in size of ≤3.0 mm versus. 18.56 ± 0.60 month in size of <3 mm; P= 0.06). A statistically significant association was found in reduced model among the size change of the pterygium and standardized coefficient was -0.012 ( = 0.044) and -0.743 ( < 0.001) for age and size of lesion before surgery, respectively.
Our findings suggest that increasing age and pterygial tissue are the risk factors for recurrence and pterygium has a substantial recurrence rate even after AMT combined with MMC.
评估羊膜移植（AMT）联合术中丝裂霉素C（MMC）治疗翼状胬肉手术的复发率及疗效。
这项前瞻性临床研究纳入了适合翼状胬肉切除术的患者。手术切除后，按照标准方案术中局部应用MMC，随后进行AMT。观察指标为复发情况及病变大小变化。进行了Kaplan-Meier估计和回归分析。
连续55例患者的55只眼接受了手术，其中男性30例（54.5%），女性25例（45.5%），平均年龄47.12±15.95岁。平均随访时间为15.21±2.67个月。总体复发率为34.5%（19/55例）。术前翼状胬肉较大者估计复发时间较短，差异无统计学意义（胬肉大小≤3.0mm者为17.14±0.58个月，<3mm者为18.56±0.60个月；P=0.06）。在简化模型中，发现翼状胬肉大小变化与复发存在统计学显著关联，术前年龄和病变大小的标准化系数分别为-0.012（P=0.044）和-0.743（P<0.001）。
我们的研究结果表明，年龄增长和翼状胬肉组织是复发的危险因素，即使在AMT联合MMC治疗后，翼状胬肉仍有较高的复发率。
