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翼状胬肉治疗中移植边缘的折叠与烧灼:一项比较性回顾性干预分析。

Tuck in versus cauterisation of graft edge in pterygium management: A comparative retrospective interventional analysis.

作者信息

Kodavoor Shreesha Kumar, Rathi Neha, Dandapani Ramamurthy

机构信息

Department of Cornea, Cataract and Refractive Services, Coimbatore, Tamil Nadu, India.

Department of The Eye Foundation Hospital, Coimbatore, Tamil Nadu, India.

出版信息

Oman J Ophthalmol. 2022 Jun 29;15(2):193-197. doi: 10.4103/ojo.ojo_277_21. eCollection 2022 May-Aug.

Abstract

PURPOSE

To compare and evaluate surgical outcome between tuck in and cauterisation in the management of primary pterygium.

MATERIALS AND METHODS

Two groups of 56 eyes and 58 eyes with primary pterygium underwent pterygium excision with conjunctival autograft fixation by tucking in alone (Group 1) and with cauterization (Group 2), respectively. A retrospective comparative analysis was done between the two groups.

RESULTS

This study included a total of 114 eyes in the final analysis. The recurrence was noted in 3 eyes in Group 1 (5.35%), whereas only 1 eye (1.72%) in Group 2. Other complications included graft edema in 25 eyes (44.64%), in Group 1 and 29 eyes (50%) in Group 2, subconjunctival hemorrhage seen in 28 eyes (50%) in Group 1 and 32 eyes (55.17%) in Group 2, graft retraction observed in 28 eyes (50%) in Group 1 and 13 eyes (22.4%) in Group 2, granuloma formation was seen only in one patient (1.72%) in Group 2, graft loss was observed in four patients (7.14%) in Group 1 and 2 patients (3.44%) in Group 2.

CONCLUSION

Graft fixation in pterygium surgery using low-cost procedures with tuck in or cauterization proves to be tolerable, safe and successful method. An additional step of fixing the graft to the cut conjunctival margin using bipolar cautery proves to be safer.

摘要

目的

比较和评估单纯结膜下植入术与烧灼术治疗原发性翼状胬肉的手术效果。

材料与方法

两组原发性翼状胬肉患者,分别为56眼和58眼,分别接受单纯结膜下植入术(第1组)和烧灼术联合结膜下植入术(第2组)进行翼状胬肉切除及结膜自体移植固定。对两组进行回顾性比较分析。

结果

最终分析共纳入114眼。第1组有3眼复发(5.35%),而第2组仅有1眼复发(1.72%)。其他并发症包括:第1组25眼(44.64%)、第2组29眼(50%)出现移植片水肿;第1组28眼(50%)、第2组32眼(55.17%)出现结膜下出血;第1组28眼(50%)、第2组13眼(22.4%)出现移植片退缩;仅第2组1例患者(1.72%)出现肉芽肿形成;第1组4例患者(7.14%)、第2组2例患者(3.44%)出现移植片丢失。

结论

在翼状胬肉手术中,采用结膜下植入术或烧灼术等低成本方法进行移植片固定,是可耐受、安全且成功的方法。使用双极电烧灼将移植片固定于结膜切口边缘这一额外步骤更为安全。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ef5/9351955/fb8255a2cfe8/OJO-15-193-g001.jpg

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