Department of Ophthalmology, Pusan National University School of Medicine, Pusan, Republic of Korea.
Hadan Sungmo Eye Hospital, Pusan, Republic of Korea.
Indian J Ophthalmol. 2021 Sep;69(9):2406-2411. doi: 10.4103/ijo.IJO_2982_20.
This study aimed to evaluate the surgical outcomes of pterygial excision for primary and recurrent pterygia by a single method of pterygia excision combined with two conjunctival flaps.
This retrospective study divided 193 cases of pterygium into the primary (140 cases) and recurrent (53 cases) pterygium groups. Following double-sliding conjunctival transposition flap operation and surgical excision of the pterygium, the success and recurrence rates of pterygial surgery were assessed based on visual acuity and corneal and total astigmatism during follow-up at least 6 months.
Both primary and recurrent pterygium groups showed significant improvements in visual acuity and astigmatism (corneal and total) between before and after this procedure. Total astigmatism and success rate of primary pterygium were significantly better than those for recurrent pterygium. Two cases (1.4%) of primary pterygium and four cases (7.5%) of recurrent pterygium developed recurrence, corresponding to a rate of 3.1% (6/193 cases). The success rates significantly make a difference between primary and recurrent groups but did not differ significantly between the first recurrent and over twice recurrent pterygium. However, visual acuity, cornea, and total astigmatism improved significantly after surgery in first recurrent group but not in over twice recurrent group.
The double-sliding conjunctival flaps surgery appeared to be a useful method, with a better success rate and lower pterygial recurrence in pterygium surgery. Especially, when pterygium is larger or recurrent type, this technique can be easily covered the bare sclera, as compared to any transposition conjunctival flap operation.
本研究旨在评估单一翼状胬肉切除术联合两种结膜瓣治疗原发性和复发性翼状胬肉的手术效果。
本回顾性研究将 193 例翼状胬肉分为原发性（140 例）和复发性（53 例）翼状胬肉组。在进行双滑行结膜瓣转位术和翼状胬肉切除术之后，根据至少 6 个月的随访期间视力以及角膜和总散光的变化，评估翼状胬肉手术的成功率和复发率。
原发性和复发性翼状胬肉组在手术前后视力和散光（角膜和总）均有显著改善。原发性翼状胬肉的总散光和成功率明显优于复发性翼状胬肉。原发性翼状胬肉中有 2 例（1.4%）和复发性翼状胬肉中有 4 例（7.5%）复发，复发率分别为 3.1%（193 例中有 6 例）。原发性和复发性组之间的成功率有显著差异，但首次复发和超过两次复发的翼状胬肉之间差异无统计学意义。然而，首次复发组手术后视力、角膜和总散光均有显著改善，但超过两次复发组无明显改善。
双滑行结膜瓣手术是一种有效的方法，在翼状胬肉手术中成功率更高，复发率更低。特别是对于较大或复发性翼状胬肉，与任何结膜瓣转位术相比，该技术更容易覆盖巩膜裸露区。
