翼状胬肉的逆向撕剥、结膜移植和巩膜强化固定法的疗效

Efficacy of pterygium reversal tear-cutting, conjunctival autograft and sclera reinforcement fixation

摘要:

目的：探讨一种改良的翼状胬肉切除术的疗效，以提高手术质量。

方法：首先从角膜缘处将胬肉从颈部剪断，再用刀尖从胬肉头部边缘外0.5mm处掀开胬肉头部，然后将胬肉从头部向颈部，即沿其生长反方向撕扯，遇到粘连较重处，用刀尖(可为15°刀、尖刀片、钻石刀等)在角膜的切线方向上平推，以辅助撕剥，剪除结膜下方的胬肉组织，从同一眼颞上方取一与暴露巩膜面等大的结膜瓣，间断缝合固定于浅层巩膜上。

结果：该法共实施于660眼，术后随访3mo，仅8眼复发，且手术时间、角膜上皮的愈合时间明显短于其他方法，角膜的光滑度和透明度、结膜的平整度均优于其他方法，恢复时间也明显缩短。

结论：逆向撕剥、结膜移植、巩膜强化固定法治疗翼状胬肉的疗效明显优于传统的单纯切除法。

Abstract:

AIM:To introduce a modified pterygium excision, so as to improve the operation quality.

METHODS:To cut the neck of the pterygiumat at limbus, then tear pterygiumat from opposite direction of head on the basis of the original excision. When resistance occurs, point of a knife(15°knife, pointed blade or diamond knife)was employed for cutting on the direction of tangent to cornea. In the process, the operation gave priority to tearing and was supplemented by cutting. A conjunctival flap was taken from the superior temporal and same size as the cut area. Conjunctival transplantation should be firmly stitched on the sclera.

RESULTS:The implementation was taken on 660 eyes. There were only 8 eyes relapsed, and the smoothness and transparency of cornea was superior to the conventional method. Recovery time was shortened obviously.

CONCLUSION:The modified method of reversal tear-cutting, conjunctival autograft and sclera reinforcement fixation is more effective than the conventional transplantation for treating pterygiumat.