Jha Ashok, Simba Abhay
Department of Ophthalmology, Military Hospital Gaya, Gaya, India.
Department of Ophthalmology, Anugrah Narayan Medical College, Gaya, India.
J Ophthalmic Vis Res. 2022 Jan 21;17(1):4-11. doi: 10.18502/jovr.v17i1.10164. eCollection 2022 Jan-Mar.
To compare outcomes of conjunctival autograft (CAG) and combined amniotic membrane with mini-simple limbal epithelial transplant (mini-SLET) after primary pterygium excision.
All consenting adults with primary pterygium were included in this study. After pterygium excision, patients were randomized to receive either CAG or mini-SLET and both grafts were held in place with fibrin glue. The patients were followed-up at days 1, 3, 7, 14, and 30 and subsequently at the third, sixth, and ninth months. The recurrence rate was considered as the primary outcome measure whereas the operating time, postoperative symptoms, and surgical complications were considered the secondary outcome measures.
The study comprised of 264 eyes of 264 patients, of which 233 (88%) completed the nine months of follow-up. Of these, 118 (51%) received CAG and 115 (49%) received mini-SLET. The groups were comparable at baseline. Recurrence of pterygium was seen in two (1.6%) eyes in the CAG group and three (2.6%) eyes in the mini-SLET group ( = 0.68). Operative time for mini-SLET (20.33 1.28 min) was significantly higher than that for CAG (12.01 1.26 min) ( 0.001). Graft displacement was observed in one case in group II ( = 0.999). The Lim Bon Siong (foreign body sensation, lacrimation, pain, and irritation) score in the CAG group was statistically significant for all four symptoms at days 1 and 3; however, at day 7, foreign body sensation, pain, and irritation scores were significantly higher for the CAG group.
In this study, the overall recurrence rate was very low and comparable between mini-SLET and the established technique of CAG after performing the primary pterygium excision. Despite a longer surgical time, mini-SLET appears to be a viable option for the management of primary pterygium.
比较原发性翼状胬肉切除术后自体结膜移植（CAG）和羊膜联合微型单纯角膜缘上皮移植（mini-SLET）的效果。
本研究纳入了所有同意参与的原发性翼状胬肉成年患者。翼状胬肉切除术后，患者被随机分配接受CAG或mini-SLET，两种移植片均用纤维蛋白胶固定在位。在第1、3、7、14和30天对患者进行随访，随后在第三、第六和第九个月进行随访。复发率被视为主要结局指标，而手术时间、术后症状和手术并发症被视为次要结局指标。
该研究包括264例患者的264只眼，其中233只眼（88%）完成了9个月的随访。其中，118只眼（51%）接受了CAG，115只眼（49%）接受了mini-SLET。两组在基线时具有可比性。CAG组有2只眼（1.6%）出现翼状胬肉复发，mini-SLET组有3只眼（2.6%）出现复发（P = 0.68）。mini-SLET的手术时间（20.33 ± 1.28分钟）显著长于CAG的手术时间（12.01 ± 1.26分钟）（P < 0.001）。第二组有1例出现移植片移位（P = 0.999）。CAG组在第1天和第3天的所有四种症状的林邦雄（异物感、流泪、疼痛和刺激）评分在统计学上均有显著差异；然而，在第7天，CAG组的异物感、疼痛和刺激评分显著更高。
在本研究中，原发性翼状胬肉切除术后，mini-SLET与成熟的CAG技术相比，总体复发率非常低且相当。尽管手术时间较长，但mini-SLET似乎是治疗原发性翼状胬肉的一个可行选择。
