Altern Ther Health Med. 2024 Jun;30(6):188-195.
Pterygium and conjunctival laxity are common ocular conditions that can significantly affect visual comfort and quality of life. Therefore, it is essential to investigate ways to treat these problems. This study aimed to compare the effectiveness of same-stage trapezoidal conjunctival flap transplantation, pterygium excision, and scleral fixation surgery versus staged pterygium excision, crescentic conjunctiva excision, and scleral fixation surgery in treating pterygium combined with conjunctival laxity. The study also aimed to evaluate the impact of these surgical techniques on postoperative complications.
From June 2019 to May 2021, 90 patients (90 eyes) with pterygium combined with conjunctival laxity were included in this study and were randomly divided into two groups (A and B) using a simple number table method. Group A underwent same-stage trapezoidal conjunctival flap transplantation, pterygium excision, and scleral fixation surgery, while group B underwent staged pterygium excision, crescentic conjunctiva excision, and scleral fixation surgery. The International Ocular Surface Disease Index (OSDI), degree of conjunctival laxity excision, changes in ocular tear film dynamics, recurrence rate, and postoperative complications were compared between the two groups.
The results showed that different surgical methods for pterygium and conjunctivochalasis did not significantly improve the symptoms and quality of life of patients. This suggests that more intensive research is needed to find more effective treatments. Therefore, the risks and benefits should be carefully considered when selecting ophthalmologic surgery, OSDI scores and fluorescein staining results of both groups were trending downward after surgery, while the breakup time of the tear film and height of the tear meniscus was increasing but there was no significant difference in the above indicators (P > .05). However, there was no significant difference in the above indicators between the two groups before surgery, at 1, 3, and 6 months, and at 1 year after surgery (P > .05). There was also no significant difference in the degree of conjunctival laxity excision between the two groups at 1 and 3 months after surgery (P > .05). Finally, there was no significant difference in the healing time of the conjunctiva and recurrence rates between the two groups (P > .05). The results showed that different surgical methods for pterygium and conjunctivochalasis did not significantly improve the symptoms and quality of life of patients. This suggests that more intensive research is needed to find more effective treatments. Therefore, the risks and benefits should be carefully considered when selecting ophthalmologic surgery.
The results of this study showed no significant differences between surgical techniques, making monitoring and management of complications after surgery even more critical. Patients need to be carefully watched for possible complications such as infection, discomfort, and inflammation. Doctors and medical teams should be alert in advance and take appropriate measures to deal with these problems in a timely manner to ensure the success of the operation and the comfort of the patient. By monitoring and proactively managing potential complications, unnecessary pain and complexity can be reduced, thereby improving patient experience and outcomes. Additionally, the study had several limitations, including a small sample size, a limited study period, and failure to consider other potential factors. These limitations need to be addressed in future studies to validate and extend the results of this study. In conclusion, same-stage trapezoidal conjunctival flap transplantation, pterygium excision, and scleral fixation surgery is an effective treatment for patients with pterygium combined with conjunctival laxity, which can improve their visual function and ocular tear film dynamics. However, careful monitoring and management of postoperative complications are necessary.
翼状胬肉和结膜松弛是常见的眼部疾病，会显著影响视觉舒适度和生活质量。因此，研究治疗这些问题的方法至关重要。本研究旨在比较同期梯形结膜瓣移植、翼状胬肉切除术和巩膜固定术与分期翼状胬肉切除术、新月形结膜切除术和巩膜固定术治疗翼状胬肉合并结膜松弛的疗效。本研究还旨在评估这些手术技术对术后并发症的影响。
2019 年 6 月至 2021 年 5 月，本研究纳入了 90 例（90 只眼）翼状胬肉合并结膜松弛患者，并采用简单数字表法将其随机分为两组（A 组和 B 组）。A 组行同期梯形结膜瓣移植、翼状胬肉切除术和巩膜固定术，B 组行分期翼状胬肉切除术、新月形结膜切除术和巩膜固定术。比较两组患者的眼表疾病指数（OSDI）、结膜松弛切除程度、眼表泪液动力学变化、复发率和术后并发症。
结果显示，不同的翼状胬肉和结膜松弛手术方法并不能显著改善患者的症状和生活质量。这表明需要进行更深入的研究，以找到更有效的治疗方法。因此，在选择眼科手术时，应仔细权衡风险和益处。OSDI 评分和荧光素染色结果显示，两组患者术后均呈下降趋势，而泪膜破裂时间和泪膜高度均呈上升趋势，但上述指标差异均无统计学意义（P >.05）。然而，两组患者在术前、术后 1 个月、3 个月和 6 个月以及 1 年时的上述指标差异均无统计学意义（P >.05）。两组患者术后 1 个月和 3 个月时的结膜松弛切除程度差异也无统计学意义（P >.05）。两组患者的结膜愈合时间和复发率差异也无统计学意义（P >.05）。结果表明，不同的翼状胬肉和结膜松弛手术方法并不能显著改善患者的症状和生活质量。这表明需要进行更深入的研究，以找到更有效的治疗方法。因此，在选择眼科手术时，应仔细权衡风险和益处。
本研究结果表明，不同的手术方法之间没有显著差异，这使得术后并发症的监测和管理更加重要。需要密切观察患者是否出现感染、不适和炎症等可能的并发症。医生和医疗团队应提前保持警惕，并及时采取适当措施处理这些问题，以确保手术的成功和患者的舒适。通过监测和积极管理潜在的并发症，可以减少不必要的疼痛和复杂性，从而改善患者的体验和结果。此外，本研究还存在一些局限性，包括样本量小、研究时间有限以及未能考虑其他潜在因素。未来的研究需要进一步验证和扩展本研究的结果。总之，同期梯形结膜瓣移植、翼状胬肉切除术和巩膜固定术是治疗翼状胬肉合并结膜松弛的有效方法，可改善患者的视觉功能和眼表泪液动力学。然而，术后并发症的监测和管理是必要的。
