5-FU和角膜绷带镜在翼状胬肉切除联合自体角膜缘干细胞移植术中的应用

Application of 5-fluorouracil and bandage contact lens in pterygium excision combined with autogenous limbal stem cell transplantation

摘要:

目的： 评价翼状胬肉切除联合自体角膜缘干细胞移植术(ALSCT)中联合应用5-氟尿嘧啶(5-FU)和角膜绷带镜治疗翼状胬肉的临床疗效。

方法：随机对照临床试验。纳入2021-05/2022-11秦皇岛市海港医院眼科收治的翼状胬肉患者71例71眼：A组23眼行翼状胬肉切除联合ALSCT，B组24眼于术中局部浸润和术后结膜下注射5-FU，C组24眼联合应用5-FU的同时并于术后配戴角膜绷带镜。比较三组患者术后1、3、7、14d的舒适度评分，术后1、3、7、14d，1mo的角膜愈合情况，术后3～6mo的手术疗效和并发症发生率。

结果：术后1、3、7d舒适度评分和术后1、3d角膜愈合情况比较， C组患者优于A、B两组。三组间术后14d的舒适度评分和术后14d、1mo的角膜愈合情况比较无差异。随访3～6mo，A组有3眼复发，B组1眼复发，C组无复发。三组患者术后并发症发生率比较无差异。

结论：联合应用5-FU和术后配戴角膜绷带镜可以优化翼状胬肉切除联合ALSCT术后眼部体验，加快角膜上皮修复，并提高的手术成功率。

Abstract:

AIM:To assess the clinical efficacy of 5-fluorouracil(5-FU)and bandage contact lens in the pterygium excision combined with autogenous limbal stem cell transplantation(ALSCT)in treating patients with pterygium.

METHODS:Random controlled clinical trial. A total of 71 patients(71 eyes)of pterygium who treated at the department of ophthalmology in Qinhuangdao Haigang Hospital between May 2021 and November 2022 were included. They were divide into three groups, including 23 eyes received pterygium excision combined with ALSCT in group A, 24 eyes that were administered with 5-FU intraoperatively and postoperatively in group B, and 24 eyes that received both bandage contact lens and 5-FU in group C. Furthermore, comfort levels at 1, 3, 7, 14d postoperatively, corneal epithelial healing at 1, 3, 7, 14d and 1mo postoperatively, treatment outcomes and complications at 3～6mo postoperatively were compared among the three groups of patients.

RESULTS:The comfort levels at 1, 3 and 7d postoperatively and corneal healing at 1 and 3d postoperatively of the group C were better than those of the groups A and B. There were no statistical significant differences in the comfort levels at 14d after surgery and corneal healing at 14d and 1mo after surgery among the three groups of patients. Over a 3～6mo follow-up period, group A experienced recurrence in 3 eyes, group B had 1 recurrence, while group C had no recurrence. There were no statistically significant differences in complication rates among the three groups of patients.

CONCLUSIONS: The application of 5-FU combined with bandage contact lens can enhance postoperative comfort levels, promote corneal epithelial healing, and improve the success rate in pterygium excision combined with ALSCT.