Aguilar-González Marina, España-Gregori Enrique, Pascual-Camps Isabel, Gómez-Lechón-Quirós Luis, Peris-Martínez Cristina
Unit of Cornea and Anterior Eye Diseases, Fundación de Oftalmología Médica (FOM), C/Pío Baroja 12, 46015 Valencia, Spain.
Hospital de Manises, Av. De la Generalitat Valenciana 50, 46949 Manises, Spain.
J Clin Med. 2024 Aug 14;13(16):4769. doi: 10.3390/jcm13164769.
The main purpose of this study is to determine, by anterior segment optical coherence tomography (AS-OCT), the anatomical characteristics, both preoperatively and postoperatively, that correlate with a higher rate of pterygium recurrence after surgery with exeresis and conjunctival autograft with biological glue. A total of 50 eyes which were listed for primary pterygium surgery at an ophthalmology tertiary centre were treated with standard pterygium excision and a conjunctival autograft with tissue glue. Ten variables were measured with AS-OCT (Casia 2; Tomey Corp., Nagoya, Japan) during six control visits with all patients. Finally, statistical analysis was performed using SPSS (SPSS stadistics, IBM, version 21.0.0.0) for descriptive variables and R-project (The R foundation©, version 3.0.2) for the rest of the analyses, including a descriptive analysis and an inferential analysis studying prognostic factors of recurrence and their predictive capacity. Among the 50 patients who underwent surgery, recurrence was detected in 8 cases (rate 16%; 95% CI: 5.8-26.2%). Most cases (n = 6) were detected 3 months after surgery. The pattern of recurrences was atrophic in two thirds of the cases; none required reintervention. Preoperative total conjunctival thickness at 3 mm was significantly increased in patients who developed recurrence. One week after surgery, epithelial and stromal thickness at 1 mm and total thickness at 3 mm proved to be useful for predicting recurrence. Both models have significant discriminant capacity. By imaging the graft with AS-OCT preoperatively and 7 days after surgery, the risk of future recurrence can be predicted.
本研究的主要目的是通过眼前节光学相干断层扫描（AS-OCT）确定，在采用手术切除联合生物胶结膜自体移植术治疗翼状胬肉后，术前和术后与较高复发率相关的解剖学特征。在一家眼科三级中心，共有50只计划接受原发性翼状胬肉手术的眼睛接受了标准的翼状胬肉切除术和组织胶结膜自体移植术。在对所有患者进行的6次对照访视期间，使用AS-OCT（Casia 2；日本名古屋Tomey公司）测量了10个变量。最后，使用SPSS（SPSS统计软件，IBM，版本21.0.0.0）对描述性变量进行统计分析，使用R-project（R基金会©，版本3.0.2）对其余分析进行统计分析，包括描述性分析和研究复发预后因素及其预测能力的推断性分析。在接受手术的50例患者中，8例检测到复发（复发率16%；95%CI：5.8-26.2%）。大多数病例（n = 6）在术后3个月检测到。三分之二的复发病例表现为萎缩性；无一例需要再次干预。复发患者术前3 mm处的结膜总厚度显著增加。术后1周，1 mm处的上皮和基质厚度以及3 mm处的总厚度被证明对预测复发有用。两种模型都具有显著的判别能力。通过术前和术后7天用AS-OCT对移植物进行成像，可以预测未来复发的风险。
