退翳明目汤联合自体角膜缘干细胞移植治疗翼状胬肉

Treatment of Tuiyi Mingmu decoction combined with autologous limbal stem cell transplantation on pterygium

摘要:

目的：探讨退翳明目汤联合自体角膜缘干细胞移植治疗翼状胬肉的临床价值。

方法：回顾性分析。收集2016-01/2018-01我院收治的翼状胬肉患者80例98眼，按治疗方式分为自体角膜缘干细胞移植组34例39眼与退翳明目汤联合自体角膜缘干细胞移植组46例59眼。比较两组患者手术前后UCVA、角膜屈光度、角膜散光度、BUT、SⅠt、角膜上皮修复时间、并发症及复发率。

结果：术前，两组患者UCVA、角膜屈光度、角膜散光度、BUT、SⅠt比较无差异(均P>0.05)，术后1mo，两组UCVA均改善，BUT、SⅠt均增加，角膜屈光度、角膜散光度均降低，退翳明目汤联合自体角膜缘干细胞移植组UCVA优于自体角膜缘干细胞移植组，角膜屈光度、角膜散光度低于自体角膜缘干细胞移植组(均P<0.05)； 退翳明目汤联合自体角膜缘干细胞移植组角膜上皮修复时间短于自体角膜缘干细胞移植组(P<0.05)，术后并发症发生率及随访12mo复发均低于自体角膜缘干细胞移植组(P<0.05)。

结论：退翳明目汤联合自体角膜缘干细胞移植可改善翼状胬肉患者视力，减轻角膜散光，促进角膜上皮细胞修复，降低复发率，且并发症少，安全性肯定。

Abstract:

AIM: To explore the clinical value of Tuiyi Mingmu decoction combined with autologous limbal stem cell transplantation in the treatment of pterygium.

METHODS: A retrospective analysis was performed to collect 80 patients(98 eyes)with pterygium admitted to the hospital from January 2016 to January 2018. The patients were divided into transplantation group(autologous limbal stem cell transplantation, n=34 cases, 39 eyes)and combined group(Tuiyi Mingmu decoction + autologous limbal stem cell transplantation, n=46 cases, 59 eyes). The uncorrected visual acuity(UCVA), corneal diopter, corneal astigmatism, tear break-up time(BUT)and Schirmer I test(S I t)tear secretion were compared between the two groups before operation and at 1mo after operation, and the corneal epithelial repair time, incidence rate of complications and recurrence rate at 12mo of follow-up were counted.

RESULTS: Before operation, there were no significant differences in the UCVA, corneal diopter and corneal astigmatism between the two groups(P>0.05). At 1mo after operation, the UCVA was increased while the corneal diopter and corneal astigmatism were decreased in the two groups, and the UCVA in combined group was higher than that in transplantation group while the corneal diopter and corneal astigmatism were lower than those in transplantation group(P<0.05). Before operation, there were no statistically significant differences in the BUT and S I t between the two groups(P>0.05). At 1mo after operation, the BUT and S I t were increased in the two groups, and the indexes in combined group were higher than those in transplantation group(P<0.05). The corneal epithelial repair time in combined group was shorter than that in transplantation group(P<0.05), and the incidence rate of postoperative complications and recurrence rate at 12mo of follow-up were lower than those in transplantation group(P<0.05).

CONCLUSION: Tuiyi Mingmu decoction combined with autologous limbal stem cell transplantation can improve the visual acuity of patients with pterygium, reduce corneal astigmatism, promote the repair of corneal epithelial cells, and reduce the recurrence rate, with few complications and definite safety.