目的:研究不同翼状胬肉切除手术前后患者术眼散光度及OrbscanⅡ角膜前后表面Diff值及角膜最陡经线屈光力的变化规律。方法:对20例23眼原发性翼状胬肉患者随机分为两组,行胬肉切除联合术中应用0.2g/LMMC者11例13眼为A组,行胬肉切除联合角膜缘干细胞10眼为B组,术前、术后1wk及术后1mo分别行OrbscanⅡ角膜地形图仪检查,记录术前术后角膜前表面Diff值,角膜后表面Diff值,术前最陡经线上屈光度及术前后角膜散光度的变化,并进行统计学分析。结果:A组、B组术后1wk,1mo的角膜前表面Diff值、最陡经线上屈光度、散光度比术前均有明显下降,差异均存在相关性(P<0.05);而两组相比,术后1wk,1mo的角膜前表面Diff值,术前最陡经线上屈光度及手术前后角膜散光度的变化,A组均比B组有明显下降,差异有显著性。两组术后1wk,1mo的角膜后表面Diff值与术前的差异无显著性差异。结论:经手术治疗,可以解除翼状胬肉对角膜的机械牵拉及压迫作用,降低散光,提高视力,手术中使用0.2g/LMMC简便可行,既可降低复发率,又能减轻术眼的角膜散光度,促进视力恢复。

AIM:To evaluate the changes of corneal topography and corneal astigmatism after pterygium excision with two different surgical methods.METHODS:Twenty-three eyes of 20 patients with primary pterygium were selected and separated into 2 groups randomly as follows:group A,pterygium excision with 0.2g/L mitomycin C(MMC) for 2 minutes intrao-peratively for 11 patients 13 eyes;group B,pterygium excision with autografting limbus stem cells trans-plantation for 9 patients 10 eyes.The changes of corneal topography and corneal astigmatism were observed by the OrbscanⅡ Corneal Topography System before the surgery and 1 week,1 month after surgery respectively.RESULTS:In both two groups,significant decreases in the results of the anterior surface of the cornea to the perfect spherical surface(Diff value),corneal curvature,and corneal astigmatism were seen after 1 week and 1 month follow-up,and the differences had statistical significances(P<0.05).In group A,the changes of those values above between postoperative and preoperative were more apparent than those in group B in statistics(P<0.05),while the posterior surface of the cornea to the perfect spherical surface(Diff value) on 1 week and 1 month after surgery had no statistical difference between two groups.And the changes of the posterior surface of the cornea to the perfect spherical surface(Diff value) between postoperative and preoperative had no statistical differences.CONCLUSION:Surgical excision combind using 0.2g/L MMC intraoperatively can release the mechanical force on cornea by pterygium,and improve topographic and clinical astigmatism significantly.This combined surgical method is efficient,it can reduce the pterygium recurrence,decrease the corneal astigmatism,and improve visual acuity as well.

R779.6