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采用 TissueTuck 技术冷冻保存羊膜:翼状胬肉手术的无缝线方法。

Cryopreserved Amniotic Membrane Using the TissueTuck Technique: A Sutureless Approach for Pterygium Surgery.

机构信息

The Eye Institute of West Florida, Largo, FL.

出版信息

Cornea. 2023 Feb 1;42(2):181-185. doi: 10.1097/ICO.0000000000003111. Epub 2022 Sep 16.

DOI:10.1097/ICO.0000000000003111
PMID:36130320
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9797198/
Abstract

PURPOSE

The purpose of this study was to evaluate the clinical outcomes of the TissueTuck technique in the management of pterygium.

METHODS

This was a single-center, retrospective review of patients with primary or recurrent pterygium that underwent surgical excision followed by application of cryopreserved amniotic membrane (AM) using the TissueTuck technique. All patients underwent surgery between January 2012 and May 2019. Patient profile, surgical time, complications, and rates of pterygium recurrence were analyzed.

RESULTS

A total of 582 eyes of 453 patients (328 female patients; 65.1 ± 13.9 years) were included for analysis and initially presented with primary (92%) pterygium. The average duration of pterygium excision surgery was 14.7 ± 5.2 minutes (median: 14, range: 4-39 minutes) with mitomycin C administration in 257 (45%) eyes. At the last follow-up of 30.2 ± 22.2 months (median: 24.5, range: 3-94 months), BCVA significantly improved from logMAR 0.23 at baseline to logMAR 0.19 ( P < 0.0001). Recurrence rate was 2.3% but only 0.7% (2/274) in those cases with primary, single-headed pterygium without mitomycin C treatment. Other postoperative complications in that cohort included granuloma (7.9%), scarring (3.8%), and diplopia in extreme lateral gaze (2.5%). The AM remained secured to the ocular surface throughout the postoperative period.

CONCLUSIONS

The TissueTuck surgical technique with cryopreserved AM can be performed in minimal time and result in a low recurrence and complication rate after pterygium surgery.

摘要

目的

本研究旨在评估 TissueTuck 技术在翼状胬肉治疗中的临床效果。

方法

这是一项单中心回顾性研究,纳入了 2012 年 1 月至 2019 年 5 月间接受手术切除联合 TissueTuck 技术应用冷冻羊膜治疗的原发性或复发性翼状胬肉患者。所有患者均接受了手术治疗。分析患者特征、手术时间、并发症和翼状胬肉复发率。

结果

共纳入 453 例患者的 582 只眼(328 例女性患者;年龄 65.1±13.9 岁),其中原发性翼状胬肉占 92%。翼状胬肉切除手术的平均时间为 14.7±5.2 分钟(中位数:14,范围:4-39 分钟),其中 257 只眼(45%)应用丝裂霉素 C。末次随访时(30.2±22.2 个月,中位数:24.5,范围:3-94 个月),BCVA 从基线时的 logMAR 0.23 显著提高至 logMAR 0.19(P<0.0001)。复发率为 2.3%,但在未应用丝裂霉素 C 且原发性、单发翼状胬肉患者中仅为 0.7%(2/274)。该队列中其他术后并发症包括肉芽肿(7.9%)、瘢痕形成(3.8%)和极端外展时复视(2.5%)。冷冻羊膜在整个术后期间均保持固定于眼表面。

结论

TissueTuck 手术联合冷冻羊膜可在最短时间内完成,且在翼状胬肉手术后复发率和并发症率低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da5/9797198/678741d5e038/cornea-42-181-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da5/9797198/9638ac453139/cornea-42-181-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da5/9797198/678741d5e038/cornea-42-181-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da5/9797198/9638ac453139/cornea-42-181-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7da5/9797198/678741d5e038/cornea-42-181-g002.jpg

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