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十年期翼状胬肉手术的临床结果:复发率和并发症发生率综述

Clinical outcomes of pterygium surgery over a ten-year period: a review of recurrence and complication rates.

作者信息

Noguera Sharlene I, Nicanor Katherine S Aniana, Ang Robert Edward T, Cruz Emerson M

机构信息

Asian Eye Institute, 9th Floor PHINMA Plaza, Rockwell Center, Makati City, 1200, Philippines.

出版信息

BMC Ophthalmol. 2025 Jul 1;25(1):380. doi: 10.1186/s12886-025-04196-4.

DOI:10.1186/s12886-025-04196-4
PMID:40596959
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12220115/
Abstract

PURPOSE

This study described the clinical profile and post-operative outcomes of patients who underwent pterygium surgery at an ambulatory eye center in the Philippines over a ten-year period.

METHODS

This retrospective study analyzed medical records of 462 eyes from 408 patients who underwent pterygium surgery by a single surgeon between February 2013 and August 2023. The study examined the clinical characteristics of patients with pterygium and evaluated the recurrence rates of three treatment methods: pterygium excision with conjunctival autograft (CAG), pterygium excision with dehydrated amniotic membrane graft (DAG), and primary excision with mitomycin C application. Descriptive statistics were used for analysis of patient demographics, clinical profile, and postoperative outcomes.

RESULTS

The mean patient age was 48 years (range 17-81), with a slight male predominance (57%). Nasal pterygium was the most common type (72%), followed by bipolar (8%) and temporal (3%) pterygium. Most cases were primary (81%), with T2G1 being the most common grading. Conjunctival autograft was the predominant surgical technique (94%), followed by dehydrated amniotic membrane graft (5%) and primary excision with mitomycin C application (1%). The overall recurrence rate was 1%, with conjunctival autograft showing the lowest rate, compared to dehydrated amniotic membrane graft and primary excision with mitomycin C. The complication rate was 4.5%, primarily minor findings such as conjunctival granuloma, wound dehiscence, and residual pterygium.

CONCLUSION

Most pterygium cases presented as primary and in the nasal area with T2G1 grading. This study supports conjunctival autograft as the preferred surgical technique for pterygium because of the low recurrence and complication rates.

摘要

目的

本研究描述了在菲律宾一家门诊眼科中心接受翼状胬肉手术的患者在十年期间的临床特征和术后结果。

方法

这项回顾性研究分析了2013年2月至2023年8月间由一名外科医生为408例患者实施的462只眼翼状胬肉手术的病历。该研究检查了翼状胬肉患者的临床特征,并评估了三种治疗方法的复发率:结膜自体移植翼状胬肉切除术(CAG)、脱水羊膜移植翼状胬肉切除术(DAG)以及丝裂霉素C应用的原发性切除术。描述性统计用于分析患者人口统计学、临床特征和术后结果。

结果

患者平均年龄为48岁(范围17 - 81岁),男性略占优势(57%)。鼻侧翼状胬肉是最常见的类型(72%),其次是双侧(8%)和颞侧(3%)翼状胬肉。大多数病例为原发性(81%),T2G1是最常见的分级。结膜自体移植是主要的手术技术(94%),其次是脱水羊膜移植(5%)和丝裂霉素C应用的原发性切除术(1%)。总体复发率为1%,与脱水羊膜移植和丝裂霉素C应用的原发性切除术相比,结膜自体移植的复发率最低。并发症发生率为4.5%,主要是结膜肉芽肿、伤口裂开和残留翼状胬肉等轻微情况。

结论

大多数翼状胬肉病例表现为原发性,位于鼻侧,分级为T2G1。由于复发率和并发症率低,本研究支持结膜自体移植作为翼状胬肉的首选手术技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c82/12220115/a8fa1d8b5d6c/12886_2025_4196_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c82/12220115/a69fe893447a/12886_2025_4196_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c82/12220115/68b81ac6e647/12886_2025_4196_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c82/12220115/a8fa1d8b5d6c/12886_2025_4196_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c82/12220115/a69fe893447a/12886_2025_4196_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c82/12220115/1f69e6f87fcf/12886_2025_4196_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c82/12220115/b9f8127f7556/12886_2025_4196_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c82/12220115/68b81ac6e647/12886_2025_4196_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c82/12220115/a8fa1d8b5d6c/12886_2025_4196_Fig5_HTML.jpg

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Korean J Ophthalmol. 2025 Jun;39(3):269-287. doi: 10.3341/kjo.2025.0003. Epub 2025 Apr 16.
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The Safety of Office-Based Pterygium Surgery.门诊翼状胬肉手术的安全性
Am J Ophthalmol. 2025 May;273:82-91. doi: 10.1016/j.ajo.2025.02.005. Epub 2025 Feb 11.
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Primary Pterygium Excision Surgery: Analysis of Risk Factors and Clinical Outcomes.原发性翼状胬肉切除术:危险因素及临床结果分析
Cureus. 2024 Jun 15;16(6):e62440. doi: 10.7759/cureus.62440. eCollection 2024 Jun.
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Modified sutureless and glue-free method versus conventional sutures for conjunctival autograft fixation in primary pterygium surgery: a systematic review and meta-analysis.改良免缝和无胶法与传统缝线在原发性翼状胬肉手术中固定结膜自体移植物的比较:系统评价和荟萃分析。
BMJ Open Ophthalmol. 2024 Apr 1;9(1):e001621. doi: 10.1136/bmjophth-2023-001621.
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The effect of different pterygium surgery techniques on the ocular surface parameters in different durations: a systematic review and meta-analysis.不同翼状胬肉手术技术对不同时间点眼表参数的影响:系统评价和荟萃分析。
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Conjunctival and Limbal Conjunctival Autograft vs. Amniotic Membrane Graft in Primary Pterygium Surgery: A 30-Year Comprehensive Review.原发性翼状胬肉手术中结膜及角膜缘结膜自体移植与羊膜移植的比较:一项30年的全面综述
Ophthalmol Ther. 2023 Jun;12(3):1501-1517. doi: 10.1007/s40123-023-00689-x. Epub 2023 Mar 24.
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Front Med (Lausanne). 2022 Nov 10;9:981663. doi: 10.3389/fmed.2022.981663. eCollection 2022.
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Evaluating the Efficacy and Safety of Different Pterygium Surgeries: A Review of the Literature.评估不同翼状胬肉手术的疗效和安全性:文献回顾。
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