翼状胬肉手术中行200mL/L酒精预处理的临床疗效观察

Observation on the effect of 200mL/L alcohol pretreatment on the pterygium operation

摘要:

目的：观察酒精预处理在翼状胬肉手术中的疗效和临床意义。

方法：翼状胬肉300眼，随机分为两组； 对照组：142眼，局部麻醉后自胬肉头部外0.5mm开始剥离并清除变性组织，再行角膜缘干细胞移植术。试验组：158眼，局部麻醉后将一个LASEK术中用来盛酒精的金属环置于胬肉头部以隔离治疗区，将数滴200mL/L酒精滴入环内，保留40～60s，然后用大量的生理盐水冲去酒精。其后手术过程同对照组。

结果：随访1mo～3a。试验组术后角膜创面光滑，组织结构完整，视觉质量提高。试验组术后角膜上皮愈合快，泪膜破裂时间延长，角膜散光平均值和总高阶像差明显降低，与对照组比较，差异有统计学意义。试验组复发率明显低于对照组，差异有统计学意义。两组并发症发生率无明显差异。

结论：酒精预处理法在翼状胬肉手术治疗中是一种安全、有效的方法。

Abstract:

AIM: To observe the effect and clinical significance of alcohol pretreatment during the pterygium surgery.

METHODS: Totally 300 eyes with pterygium were randomly divided into two groups. Control group: 142 eyes with pterygium were peeled under local anethesia and their degenerative organization of pterygium was cleaned up followed by a transplantation of corneal limbus with an autologous conjunctival flap. Experimental group: 158 eyes with pterygium were placed with a special metal ring used in LASEK on the head of pterygium to isolate the treatment area under local anesthesis, then, the treatment area within the ring was filled with the alcohol with a concentration of 200mL/L for 40-60s, followed by an adequate flushing with saline. Subsequent surgical procedure was the same as control group.

RESULTS: Follow-up for all patients ranged from 1 month to 3 years. Postoperatively, 158 eyes of experimental group had better operative effect than control group. Experimental group had better would healing, complete tissue construction, and improved visual quality. The break-up time of tear film for experimental group was significantly prolonged than that for control group. The average corneal astigmatism and total higher-order aberrations of experimental group were significantly lower than that of control group. The recurrence rate of experimental group was also significantly lower than control group. There's no significant difference in the incidence of complications.

CONCLUSION: Alcohol pretreatment during the pterygium surgery is a safe and effective method.