Ophthalmology, Private Konyagoz Hospital, Konya, Turkey.
Ophthalmology, Karaman Selcuklu Hospital, Karaman, Turkey.
Klin Monbl Augenheilkd. 2024 Jul;241(7):819-827. doi: 10.1055/a-1648-4753. Epub 2021 Nov 8.
The main complication of primary pterygium surgery is the recurrence of the pterygium. In the present study, we aimed to compare a classical technique and facilitated tenon-free conjunctival autograft preparation and a limited tenon removal technique in pterygium surgery in terms of recurrence rate, complications, and operation duration.
This is a retrospective, comparative, observational study. Group 1 comprised 120 eyes of 115 patients who underwent pterygium excision with a new facilitated tenon-free conjunctival-limbal autograft preparation and limited tenon removal technique between May 2017 and October 2019. Group 2 comprised 117 eyes of 113 patients who underwent pterygium excision with a conventional conjunctival-limbal autograft technique between January 2016 and May 2017.
The mean follow-up time after surgery was 18.2 ± 5.8 months in group 1 and 19.1 ± 6.3 months in group 2 (p = 0.25). The mean operation duration was 5.54 ± 1.22 (4 - 7) minutes in group 1 and 8.23 ± 1.26 (8 - 10) minutes in group 2 (p = 0.02). Flap edema was present in 33 eyes (28.2%) in group 2 and in 11 eyes (9.16%) in group 1. Flap edema was significantly higher in group 2 (p < 0.001). At the end of the 1-year follow-up of the patients, we observed recurrence in only one (0.83%) eye in group 1 and 14 (11.96%) eyes in group 2. The recurrence rate of group 1 was significantly less than that of group 2 (p < 0.001).
The simplified technique of tenon-free conjunctival autograft preparation and limited tenon removal yielded better clinical outcomes without serious complications. Additionally, this technique shortened the surgical time and reduced surgeon-dependent factors.
原发性翼状胬肉手术的主要并发症是翼状胬肉复发。在本研究中，我们旨在比较经典技术与简化的无肌腱结膜自体移植制备和有限的肌腱切除技术在翼状胬肉手术中的复发率、并发症和手术时间。
这是一项回顾性、对比性、观察性研究。第 1 组包括 115 例 120 只眼，于 2017 年 5 月至 2019 年 10 月行翼状胬肉切除联合新的简化无肌腱结膜-角膜缘自体移植制备和有限肌腱切除技术；第 2 组包括 113 例 117 只眼，于 2016 年 1 月至 2017 年 5 月行传统的结膜-角膜缘自体移植技术。
第 1 组术后平均随访时间为 18.2±5.8 个月，第 2 组为 19.1±6.3 个月（p=0.25）。第 1 组的平均手术时间为 5.54±1.22（4-7）分钟，第 2 组为 8.23±1.26（8-10）分钟（p=0.02）。第 2 组有 33 只眼（28.2%）出现瓣水肿，第 1 组有 11 只眼（9.16%）出现瓣水肿。第 2 组瓣水肿明显高于第 1 组（p<0.001）。在患者 1 年随访结束时，第 1 组仅观察到 1 只眼（0.83%）复发，第 2 组有 14 只眼（11.96%）复发。第 1 组的复发率明显低于第 2 组（p<0.001）。
简化的无肌腱结膜自体移植制备和有限的肌腱切除技术具有更好的临床效果，且无严重并发症。此外，该技术缩短了手术时间，减少了术者依赖性因素。
