Yap Jin Yi, Tai Evelyn Li Min, Kueh Yee Cheng, Salleh Salzihan, Ibrahim Mohtar
Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Int Ophthalmol. 2025 Jan 20;45(1):29. doi: 10.1007/s10792-024-03390-5.
To evaluate the effects of pre-operative ranibizumab injection on microvascular density (MVD), 8-hydroxyguanosine (8-OHdG) and recurrence after surgical excision of primary pterygium.
This was a prospective cohort interventional study involving 52 patients with primary pterygium divided equally into control and intervention groups. The intervention group received 0.5 mg ranibizumab two weeks prior to pterygium excision surgery. All participants had pterygium excision with autologous conjunctival graft under local anaesthesia. Excised pterygium tissues were evaluated for MVD and 8-OHdG. Each participant was monitored for recurrence up to 2 years after intervention. Pearson chi-square and Fisher exact tests were used to examine the differences between both groups.
The intervention group demonstrated significantly lower MVD (p < 0.001) and recurrence rates (p < 0.001). In the intervention group, 53.8% (n = 14) of patients had MVD 1 + , and 46.2% (n = 12) had MVD 2 + , which was notably lower than the control group, where 53.8% (n = 14) of patients had MVD 3 + and 4 + . No significant difference in 8-OHdG scores was observed between the groups (p = 0.482). In the intervention group, 84.6% (n = 22) of patients had an 8-OHdG score of 3 + , while 76.9% (n = 20) of patients in the control group also had 8-OHdG scores of 3 + . 46.2% (n = 12) of patients from the control group experienced recurrent pterygium, while no cases of pterygium recurrence were observed in the intervention group. Reduction in MVD was significantly associated with lower frequency of pterygium recurrence (p = 0.004).
Pre-operative intralesional ranibizumab decreases pterygium recurrence rate after surgical excision via modulation of vascularity. Ranibizumab may be considered as an adjunctive treatment in pterygium surgery with high risk of recurrence.
评估术前注射雷珠单抗对原发性翼状胬肉手术切除后的微血管密度（MVD）、8-羟基鸟苷（8-OHdG）及复发情况的影响。
这是一项前瞻性队列干预研究，纳入52例原发性翼状胬肉患者，平均分为对照组和干预组。干预组在翼状胬肉切除术前两周接受0.5mg雷珠单抗注射。所有参与者均在局部麻醉下接受翼状胬肉切除联合自体结膜移植术。对切除的翼状胬肉组织进行MVD和8-OHdG评估。对每位参与者随访至干预后2年，观察复发情况。采用Pearson卡方检验和Fisher精确检验比较两组间差异。
干预组的MVD（p < 0.）和复发率（p < 0.）显著降低。干预组中，53.8%（n = 14）的患者MVD为1+，46.2%（n = 12）的患者MVD为2+，明显低于对照组，对照组中53.8%（n = 14）的患者MVD为3+和4+。两组间8-OHdG评分无显著差异（p = 0.482）。干预组中，84.6%（n = 22）的患者8-OHdG评分为3+，而对照组中76.9%（n = 20）的患者8-OHdG评分也为3+。对照组中46.2%（n = 12）的患者出现翼状胬肉复发，而干预组未观察到翼状胬肉复发病例。MVD降低与翼状胬肉复发频率降低显著相关（p = 0.004）。
术前病灶内注射雷珠单抗可通过调节血管生成降低手术切除后翼状胬肉的复发率。对于复发风险高的翼状胬肉手术，雷珠单抗可考虑作为辅助治疗。
