[关键词]
[摘要]
目的:比较取自上方与下方的带角膜缘干细胞的球结膜移植治疗翼状胬肉的疗效,以及术后球结膜瘢痕化对日后行青光眼滤过手术的影响。
方法:对182例252眼初发翼状胬肉患者随机抽签法分成两组,A组85例110眼行翼状胬肉切除联合上方自体角膜缘干细胞移植,B组97例142眼翼状胬肉切除联合下方自体角膜缘干细胞植治疗翼状胬肉,术后1~12mo随访,观察两组的复发率和取自体角膜缘干细胞后球结膜瘢痕情况,以及对日后行青光眼滤过手术的影响。
结果:随访1~12mo,A组和B组术后复发率相比较,差异无统计学意义(χ2=0.015,P>0.05)。A组取上方自体角膜缘干细胞后造成上方球结膜的瘢痕化; B组取下方自体角膜缘干细胞造成下方球结膜瘢痕化。因常规行青光眼滤过手术,通常选在正上方、鼻上或颞上方球结膜区,B组保留了上方健康的球结膜,为日后行青光眼滤过手术保留了手术区域。
结论:上方与下方取自体角膜缘干细胞移植均能有效地治疗翼状胬肉,但下方取自体角膜缘干细胞移植能为日后行青光眼滤过手术保留手术区域。
[Key word]
[Abstract]
AIM: To compare the curative effect of autologous corneal limbus stem cell with bulbar conjunctiva transplantation of supprior-inferior bulbar conjunctiva in the treatment of pterygium and effect of postoperative scarring on bulbar conjunctiva on performing glaucoma filtration surgery in the future.
METHODS: A total of 182 patients(252 eyes)with initial pterygium were divided into two groups by sortition randomization method. Eighty-five patients of the group A(110 eyes)accepted pterygium resection combined stem cell transplantation of supprior autologous corneal limbus, while 97 patients of the group B(142 eyes)of pterygium excision combined stem cell transplantation of inferior autologous corneal limbus in treatment of pterygium. Postoperative follow-up from 1~12mo. Recurrence rate and conjunctival scar formation after autologous corneal limbus stem cells being taken were observed in the two groups to judge the impact on the future glaucoma filtration surgery.
RESULTS: After follow-up from 1~12mo, there was no significant difference of postoperative recurrence between the group A and group B(χ2=0.015, P>0.05). Stem cell taken from supprior autologous corneal limbus in the group A caused supprior bulbar conjunctiva scarring, while it caused inferior scarring in the group B. For routine glaucoma filtration surgery usually is being done in the upper bulbar conjunctiva, on the nose or superior bulbar conjunctival area above the temporal region, and the above healthy bulbar conjunctiva has being kept in the group B which retained area for future glaucoma filtration surgery.
CONCLUSION: Autologous corneal limbus stem cell transplantation of supprior-inferior bulbar conjunctiva could be effective in the treatment of pterygium, but stem cell transplantation of inferior autologous corneal limbus could keep area for glaucoma filtration surgery.
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