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翼状胬肉手术中不同自体结膜移植技术后角膜曲率变化的比较。

Comparison of Keratometric Change Following Various Conjunctival Autografting Techniques in Pterygium Surgery.

作者信息

Sen Snigdha, Jain Anu, Upadhyay Prerna, Imchen Merensoba T, Nath Tirupati, Kakkar Akash

机构信息

Department of Ophthalmology, Sarojini Naidu Medical College, Agra, IND.

Department of Ophthalmology, Government Medical College, Autonomous State Medical College, Firozabad, IND.

出版信息

Cureus. 2023 Nov 29;15(11):e49662. doi: 10.7759/cureus.49662. eCollection 2023 Nov.

Abstract

Aim To compare the postoperative keratometric changes and duration of surgery for different techniques of conjunctival autografting in pterygium surgery. Methods Patients with primary pterygium attending the outpatient department and having appropriate indications for surgery were enrolled. Preoperative ophthalmic examination included visual acuity assessment, refraction, keratometry, slit lamp, and fundus evaluation. Pterygium excision surgery with conjunctival autografting was performed on all patients using one of the four different techniques, namely, sutures, fibrin glue, and the autologous blood and bridge techniques. Duration of surgery was recorded for all patients. Postoperatively, all patients were followed up on Day 1, Day 7, and Months 1, 3, and 6. Duration of surgery, keratometric changes, and recurrence rates were analyzed in all four groups. Results Sixty-eight eyes of 66 patients completed the study protocol. There was a significant reduction in astigmatism after the autologous blood graft technique ( value 0.0055) and the glue technique ( value < 0.0001). The success rate of the autologous and glue technique was 90%. The glue technique was found to be more time efficient (mean duration 20.40 minutes) than other techniques. Conclusion After pterygium excision, conjunctival auto grafting using either autologous blood or glue plays a significant role in reducing pterygium-induced astigmatism and recurrence rates with the added advantage of a shorter operative time.

摘要

目的 比较翼状胬肉手术中不同结膜自体移植技术的术后角膜曲率变化及手术时长。方法 纳入在门诊就诊且有合适手术指征的原发性翼状胬肉患者。术前眼科检查包括视力评估、验光、角膜曲率测量、裂隙灯检查和眼底评估。所有患者均采用四种不同技术之一进行翼状胬肉切除联合结膜自体移植手术,即缝线技术、纤维蛋白胶技术、自体血技术和桥接技术。记录所有患者的手术时长。术后,所有患者在第1天、第7天以及第1、3和6个月进行随访。分析四组患者的手术时长、角膜曲率变化及复发率。结果 66例患者的68只眼完成了研究方案。自体血移植技术(值0.0055)和胶水技术(值<0.0001)术后散光显著降低。自体血技术和胶水技术的成功率为90%。发现胶水技术比其他技术更省时(平均时长20.40分钟)。结论 翼状胬肉切除术后,使用自体血或胶水进行结膜自体移植在降低翼状胬肉所致散光和复发率方面发挥重要作用,且具有手术时间较短的额外优势。

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