Starc S, Knorr M, Steuhl K P, Rohrbach J M, Thiel H J
Abteilung I, Universitäts-Augenklinik, Tübingen.
Ophthalmologe. 1996 Jun;93(3):219-23.
The aim of the present study was evaluation of the efficiency of limbal autograft transplantation for primary and recurrent pterygia. The results of limbal autograft transplantation for advanced and recurrent pterygia are presented for 58 eyes of 50 patients. The pterygia were primary in 40 eyes and recurrent in 18 eyes. Free grafts from the superotemporal limbus of the same eye were used to cover the exposed sclera. Postoperative followup ranged from 2 to 26 months, with a mean of 13 months. The overall recurrence rate was 31% (22.5% in primary pterygia and 50% in recurrent pterygia). Recurrence rates were significantly higher in patients from southern Europe than in patients from northern Europe. Analysis of patients with recurrences (n = 18) revealed severe tear film abnormalities in eight cases. Seven patients were found to have transplants of insufficient size. Analysis of our results provides evidence that the experience of the surgeon is crucial for the success rate of this procedure. Three of six surgeons with limited experience had a recurrence rate of 50% or more. Additionally, 15 patients who developed recurrent pterygium had returned to unfavourable working conditions (e.g. dust, heat). Three of the 18 recurrences underwent repeated limbal transplantation and in one of these there was a further recurrence.
本研究的目的是评估自体角膜缘移植治疗原发性和复发性翼状胬肉的疗效。本文报告了50例患者58只眼行自体角膜缘移植治疗进展期和复发性翼状胬肉的结果。其中40只眼为原发性翼状胬肉，18只眼为复发性翼状胬肉。取自同眼颞上象限角膜缘的游离植片用于覆盖暴露的巩膜。术后随访时间为2至26个月，平均13个月。总体复发率为31%（原发性翼状胬肉为22.5%，复发性翼状胬肉为50%）。南欧患者的复发率显著高于北欧患者。对复发患者（n = 18）的分析显示，8例患者存在严重的泪膜异常。7例患者的移植片尺寸不足。对我们研究结果的分析表明，外科医生的经验对该手术的成功率至关重要。六位经验有限的外科医生中有三位的复发率达到或超过50%。此外，15例发生复发性翼状胬肉的患者恢复了不利的工作条件（如多尘、高温环境）。18例复发患者中有3例接受了再次角膜缘移植，其中1例再次复发。
