Trufanov S V
Research Institute of Eye Diseases, Moscow, Russia.
Vestn Oftalmol. 2020;136(5. Vyp. 2):214-218. doi: 10.17116/oftalma2020136052214.
As it is known, the main problem of surgical treatment of pterygium is associated with high risk of recurrence. Quite a number of surgical techniques now exist, all aimed at pterygium removal and only differing in the method of conjunctival closure following the excision. Due to relatively low recurrence rates, conjunctival or conjunctival-limbal autografts are currently the 'gold standard' of pterygium surgery. The frequency of recurrence is also insignificant in peripheral anterior lamellar keratoplasty, which is rarely performed due to its complexity and the need for donor cornea. However, it is considered to be the method of choice in cases of repeated recurrence as well as in patients with high pterygium activity. This article describes a clinical case of a massive recurrent pterygium (grade IV, activity level 3). The patient has had three previous surgeries (including conjunctival autotransplantation) that yielded no success. By performing large-diameter peripheral anterior lamellar keratoplasty in combination with adjuvant therapy (intraoperative mitomycin C and subconjunctival postoperative aflibercept injections), structural integrity of the cornea was finally restored without further recurrences and visual acuity was increased.
众所周知，翼状胬肉手术治疗的主要问题与高复发风险相关。目前存在相当多的手术技术，所有这些技术都旨在切除翼状胬肉，只是在切除后结膜闭合的方法上有所不同。由于复发率相对较低，结膜或结膜-角膜缘自体移植目前是翼状胬肉手术的“金标准”。周边前板层角膜移植术的复发频率也不高，由于其复杂性和对供体角膜的需求，这种手术很少进行。然而，它被认为是复发病例以及翼状胬肉活动度高的患者的首选方法。本文描述了一例巨大复发性翼状胬肉（IV级，活动度3级）的临床病例。该患者此前已接受过三次手术（包括结膜自体移植），均未成功。通过进行大直径周边前板层角膜移植术并结合辅助治疗（术中使用丝裂霉素C和术后结膜下注射阿柏西普），最终恢复了角膜的结构完整性，且未再复发，并提高了视力。
