目的：分析改良式翼状胬肉切除联合自体角膜缘干细胞移植(CAT)术治疗翼状胬肉的疗效。

方法：选取2018-01/2021-01在本院眼科就诊的翼状胬肉患者140例154眼，按随机数字表法进行分组，观察组70例76眼采用改良式翼状胬肉切除联合CAT术治疗，术中使用改良虹膜恢复器； 对照组70例78眼采用常规翼状胬肉切除联合CAT术治疗，术中使用传统虹膜恢复器。术后随访1a，比较两组患者的视力、主观症状和结膜体征(结膜充血、结膜水肿)评分、角膜上皮愈合情况及术后并发症和复发情况。

结果：与术前比较，两组患者术后1、3、5d时视力均显著下降(P<0.05)，但组间均无差异(P>0.05)； 与术后1d比较，两组患者术后3、5、14d时主观症状评分、结膜充血程度和结膜水肿程度评分均显著下降(P<0.05)，且观察组术后3、5、14d时主观症状评分、结膜充血程度和结膜水肿程度评分均显著低于对照组(P<0.05)； 观察组术后3、5、14d时角膜荧光素染色(FL)评分均显著低于对照组，角膜上皮缺损修复时间≤5d的患者比例显著高于对照组(P<0.05)。观察组结膜肉芽肿、睑球黏连等并发症发生率及复发率显著低于对照组(P<0.05)。

结论：改良式翼状胬肉切除联合CAT术治疗翼状胬肉疗效可靠，可减轻术后刺激症状、结膜充血及结膜水肿程度，更利于术后角膜上皮修复，于降低术后并发症及复发率有益。

METHODS: A total of 140 patients(154 eyes)with pterygium treated in the ophthalmology department of our hospital from January 2018 to January 2021 were selected and grouped according to random number table method. In the observation group, 70 cases(76 eyes)were treated with modified pterygium excision combined with CAT, and improved iris restorer was used during the operation. In the control group, 70 patients(78 eyes)were treated with conventional pterygium excision combined with CAT, during which traditional iris restorer was used. Follow up for 1a, the postoperative vision, subjective symptoms, conjunctival signs(conjunctival congestion and chemosis), corneal epithelial healing, postoperative complications and recurrence rate were compared between the two groups.

RESULTS: Compared with pre-operation, vision of the two groups decreased significantly on 1, 3 and 5d after operation(P<0.05), while there was no statistically significant difference between the groups(P>0.05). Compared with 1d after operation, the scores on subjective symptoms, conjunctival hyperemia and edema in the two groups decreased significantly on 3, 5 and 14d after operation(P<0.05), and those scores of the observation group on 3, 5 and 14d after operation were significantly lower than those of control group(P<0.05).The corneal fluorescein staining(FL)scores of the observation group on 3, 5 and 14d after operation were significantly lower than those of the control group(P<0.05). The proportion of repair time of corneal epithelial defect ≤5d in the observation group was significantly higher than that in the control group(P<0.05). The incidence rates of conjunctival granuloma, symblepharon, and the recurrence rate in the observation group were significantly lower than those in the control group(P<0.05).

CONCLUSION: Modified pterygium resection combined with CAT is effective in the treatment of pterygium, which can alleviate postoperative irritative symptoms, conjunctival congestion and edema, and it is more conducive to postoperative corneal epithelial reconstruction, reduction of postoperative complications and recurrence rate.