McCoombes J A, Hirst L W, Isbell G P
Department of Surgery, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia.
Ophthalmology. 1994 Jan;101(1):169-73. doi: 10.1016/s0161-6420(94)31369-8.
The major problems after pterygium removal are recurrence and complications of the therapy. The authors investigated a simple surgical treatment without adjunctive therapy for primary pterygium.
Patients eligible to be included in the study were identified from a pterygium treatment log. They represent consecutive cases over a 6 1/2-year period, all of whom had been treated by one surgeon using a superior, sliding, conjunctival flap to cover the pterygium defect. An attempt was made to obtain follow-up of at least 1 year for each patient.
Two hundred fifty-eight eyes in 236 patients were included in the study. Two hundred twenty-two eyes (86%) were able to be followed by either record review or re-examination. Seven pterygia (3.2%) recurred, all identified by record review, with no recurrences identified by re-examination. Recurrences were more likely after early postoperative flap retraction (5 of 7 recurrences) and recurrence occurred at a mean interval of 4.3 months (range, 1.5-11 months) after surgery. Symptomatically, the patients were comfortable, and the cosmetic result was good.
This study indicates that this simple surgical procedure for the treatment of primary pterygium should be evaluated further by controlled clinical trials.
翼状胬肉切除术后的主要问题是复发和治疗并发症。作者研究了一种用于原发性翼状胬肉的无辅助治疗的简单手术方法。
从翼状胬肉治疗记录中确定符合纳入研究条件的患者。他们代表了6年半期间的连续病例，所有患者均由一名外科医生采用上方滑动结膜瓣覆盖翼状胬肉缺损进行治疗。试图对每位患者进行至少1年的随访。
236例患者的258只眼纳入研究。222只眼（86%）通过记录复查或再次检查得以随访。7只翼状胬肉（3.2%）复发，均通过记录复查发现，再次检查未发现复发。早期术后皮瓣回缩后复发的可能性更大（7例复发中有5例），复发发生在术后平均4.3个月（范围1.5 - 11个月）。从症状上看，患者感觉舒适，美容效果良好。
本研究表明，这种治疗原发性翼状胬肉的简单手术方法应通过对照临床试验进一步评估。
