Karabatsas C H, Marsh G W, Cook A M, Cook S D
University of Bristol, Department of Ophthalmology, Bristol Eye Hospital, U.K.
Eur J Ophthalmol. 1998 Jul-Sep;8(3):148-52. doi: 10.1177/112067219800800305.
This study was initiated to investigate the role of different therapeutic modalities in the outcome of the surgical treatment of pterygium.
The results of treatment of pterygia with a variety of surgical techniques were studied in 56 eyes (49 patients) operated on at Bristol Eye Hospital during a period of five years. The surgical techniques included simple excision; bare sclera; conjunctival autograft; sliding conjunctival flap; lamellar keratoplasty and penetrating keratoplasty. Twelve eyes received additional beta irradiation in a fractionated total dose of 40 Gys.
The incidence of recurrence was 23.2% for the 43 treated primary pterygia, and 23% for the 13 recurrent pterygia. All recurrences occurred between 2.5 and 11 months postoperatively. None of the 11 cases where additional beta irradiation was used showed any recurrence or other complication within the study period. In the recurrent pterygia group, the cases treated with a combination of surgical excision and beta irradiation, showed significantly lower recurrence rate (p < 0.001) compared to those cases treated with surgical excision alone.
Beta irradiation as a complement to surgical treatment of pterygium, is successful in treating high risk cases such as reoperations, whereas for the majority of primary pterygia surgical excision alone is adequate. Additionally, follow up of one year will reveal any recurrences.
开展本研究以调查不同治疗方式在翼状胬肉手术治疗结果中的作用。
对布里斯托尔眼科医院在五年期间接受手术的56只眼（49例患者）采用多种手术技术治疗翼状胬肉的结果进行了研究。手术技术包括单纯切除；裸巩膜；结膜自体移植；滑行结膜瓣；板层角膜移植术和穿透性角膜移植术。12只眼接受了总剂量为40戈瑞的分次β射线照射。
43例原发性翼状胬肉治疗后的复发率为23.2%，13例复发性翼状胬肉的复发率为23%。所有复发均发生在术后2.5至11个月之间。在使用额外β射线照射的11例病例中，在研究期间均未出现任何复发或其他并发症。在复发性翼状胬肉组中，与单纯手术切除治疗的病例相比，采用手术切除和β射线照射联合治疗的病例复发率显著更低（p < 0.001）。
β射线照射作为翼状胬肉手术治疗的补充，在治疗高风险病例如再次手术时是成功的，而对于大多数原发性翼状胬肉，单纯手术切除就足够了。此外，一年的随访将发现任何复发情况。
