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20%乙醇在改善翼状胬肉手术效果中的作用:一项临床研究。

The Role of 20% Ethanol in Enhancing Pterygium Surgery Outcomes: A Clinical Study.

作者信息

Mudhol Rekha R, K Shilpa

机构信息

Ophthalmology, Shri BM Patil Medical College, Bijapur Lingayat District Education (BLDE) (Deemed to be University), Vijayapura, IND.

出版信息

Cureus. 2024 Jul 31;16(7):e65830. doi: 10.7759/cureus.65830. eCollection 2024 Jul.

DOI:10.7759/cureus.65830
PMID:39219973
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11364500/
Abstract

Introduction Pterygium is an ocular surface disorder characterized by a hyperplastic growth of conjunctiva encroaching over the cornea. It causes redness, watering, and foreign body sensation. Surgical excision is the preferred mode of treatment when there is encroachment over the visual axis, chronic irritation, restricted ocular motility, and cosmetic concerns. Various surgical methods have been adopted for the treatment and to prevent recurrences. This study assessed the effectiveness and safety of 20% ethanol as an adjuvant in pterygium excision with conjunctival autograft implantation, evaluating surgical outcomes. Methods A prospective hospital-based interventional study was conducted among 30 patients with pterygium from August 2022 to December 2023. Patients were evaluated preoperatively for anterior segment, posterior segment, visual acuity, and corneal astigmatism. Pterygium was excised using 20% ethanol as an adjuvant, and conjunctival autograft was placed over the bare sclera without sutures. Patients were evaluated on postoperative days 1, 8, 30, and 90 for graft condition, visual acuity, corneal astigmatism, and associated complications. Results After three months of follow-up, the mean visual acuity improved to LogMAR 0.46±0.35 (p=0.001), which was statistically significant, and the average corneal astigmatism decreased from 3.36±2.87 to 0.87±0.57 (p=0.0001). No recurrence was noted among the participants. Conclusion This study has shown that using 20% ethanol as an adjuvant for pterygium excision facilitated clean dissection of a pterygium from the underlying cornea and the pterygium-induced corneal astigmatism has significantly decreased, which led to progress in vision.

摘要

引言 翼状胬肉是一种眼表疾病,其特征为结膜增生性生长并侵犯角膜。它会导致眼红、流泪和异物感。当翼状胬肉侵犯视轴、引起慢性刺激、限制眼球运动或存在美容问题时,手术切除是首选的治疗方式。为了治疗和预防复发,人们采用了各种手术方法。本研究评估了20%乙醇作为辅助剂在翼状胬肉切除联合结膜自体移植术中的有效性和安全性,并对手术结果进行了评估。

方法 2022年8月至2023年12月,对30例翼状胬肉患者进行了一项基于医院的前瞻性干预研究。术前对患者的眼前段、眼后段、视力和角膜散光进行评估。使用20%乙醇作为辅助剂切除翼状胬肉,并将结膜自体移植片放置在裸露的巩膜上,无需缝合。在术后第1天、第8天、第30天和第90天对患者的移植片情况、视力、角膜散光和相关并发症进行评估。

结果 经过三个月的随访,平均视力提高到LogMAR 0.46±0.35(p=0.001),具有统计学意义,平均角膜散光从3.36±2.87降至0.87±0.57(p=0.0001)。参与者中未发现复发情况。

结论 本研究表明,使用20%乙醇作为翼状胬肉切除的辅助剂有助于从下方角膜干净地切除翼状胬肉,且翼状胬肉引起的角膜散光显著降低,从而使视力得到改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a07c/11364500/7a2ae2034948/cureus-0016-00000065830-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a07c/11364500/fe0d61ad92de/cureus-0016-00000065830-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a07c/11364500/156772859809/cureus-0016-00000065830-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a07c/11364500/f1f65f1e7882/cureus-0016-00000065830-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a07c/11364500/5647ec9b7fe7/cureus-0016-00000065830-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a07c/11364500/7a2ae2034948/cureus-0016-00000065830-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a07c/11364500/fe0d61ad92de/cureus-0016-00000065830-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a07c/11364500/156772859809/cureus-0016-00000065830-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a07c/11364500/f1f65f1e7882/cureus-0016-00000065830-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a07c/11364500/5647ec9b7fe7/cureus-0016-00000065830-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a07c/11364500/7a2ae2034948/cureus-0016-00000065830-i05.jpg

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本文引用的文献

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The association of sun exposure, ultraviolet radiation effects and other risk factors for pterygium (the SURE RISK for pterygium study) in geographically diverse adult (≥40 years) rural populations of India -3rd report of the ICMR-EYE SEE study group.印度不同地理区域、成年(≥40 岁)农村人群中翼状胬肉(SURE RISK 翼状胬肉研究)的阳光暴露、紫外线辐射效应及其他危险因素的相关性-ICMR-EYE SEE 研究组的第 3 次报告。
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