Schrage N F, Kuckelkorn R, Joisten M, Reim M
Augenklinik, Medizinische Fakultät der RWTH Aachen.
Ophthalmologe. 1993 Dec;90(6):691-3.
A retrospective examination was conducted on 104 patients who had undergone operations for a pterygium over a time period of 2-73 months. Thirty-one patients were operated on with a free autologous conjunctival transplant; in 40 cases a conjunctival suture was performed and in 33 cases the bare sclera technique was used. The pterygium and any recurrences were scored clinically from 0 to 4. Small recurrences with a score less than 3 and a small conjunctival corpus were called "calm" recurrences. A bigger corpus and a head with a score > or = 3 and parallel vessels were called "active" recurrences. The recurrence rates were taken as the total calm and active recurrences. Autologous conjunctival transplant had a recurrence rate of 32.3%, excision with conjunctival suture 58.5%, and the bare sclera technique had a recurrence rate of 66.7%. Excision techniques cause high rates of recurrences, severe conjunctival scarification and irritation for a long time. A free autologous conjunctival transplant from the same or other eye to the place of excision improves the rate of recurrences even when the condition is more severe initially. Even though more complicated operation methods decrease the rate of recurrence, but 20-35% recurrence rates are still not satisfactory.
对104例在2至73个月内接受翼状胬肉手术的患者进行了回顾性检查。31例患者接受了自体结膜游离移植手术；40例进行了结膜缝合，33例采用了单纯巩膜术。临床上将翼状胬肉及其任何复发情况从0至4进行评分。评分低于3且结膜体较小的小复发称为“静止”复发。结膜体较大且头部评分≥3且有平行血管的称为“活动”复发。复发率以静止和活动复发的总数计算。自体结膜移植的复发率为32.3%，结膜缝合切除为58.5%，单纯巩膜术的复发率为66.7%。切除技术导致高复发率、严重的结膜瘢痕形成和长期刺激。即使最初病情更严重，将来自同一只眼或另一只眼的自体结膜游离移植到切除部位也能提高复发率。尽管更复杂的手术方法降低了复发率，但20%至35%的复发率仍不尽人意。
