目的：比较翼状胬肉切除联合自体结膜-角膜缘移植术与联合该术式加干态生物羊膜覆盖方案在黔东南地区治疗翼状胬肉的临床疗效。

方法：采用单中心回顾性队列研究，纳入 2023年4月至2025年6月在黔东南爱尔眼科医院就诊、常住本地时长≥5 a的原发性鼻侧翼状胬肉患者。按手术方式分两组，A组行翼状胬肉切除联合自体结膜-角膜缘移植术； B组在上述术式基础上，加生物干态羊膜(规格 10 mm×15 mm)覆盖创面。分别对比两组患者术前基线特征、术后1 d疼痛与眼表刺激症状、术后并发症发生情况、术后6 mo复发率及手术区效果分级差异。

结果：纳入患者 60 例60 眼，每组各30例30眼。A组男18例，女12例，平均年龄56.57±9.34岁； B组男12例，女18例，平均年龄55.60±9.23岁。两组患者术前性别、年龄、胬肉长入角膜长度等基线资料比较均无差异(均P>0.05)。术后1 d，A组疼痛18眼(60%)，B组10眼(33%)(P=0.038)； A组患者出现异物感、畏光、流泪等刺激症状为17眼(57%)，B组为5眼(17%)(P=0.001)。短期术后并发症：术后10 d，A组结膜充血11眼，B组7眼(P=0.260)； 术后1 mo，A组发生3眼结膜肉芽肿，B组未发生同类病例(P=0.237)。术后6 mo翼状胬肉的复发情况：A组发生4眼(13%)，B组未有复发(P=0.112)。术后6 mo手术效果分级显示，A组1级9眼(30%)、2级11眼(37%)、3级6眼(20%)、4级4 眼(13%)； B组1级15眼(50%)、2级14 眼(47%)、3级1眼(3%)、4级0 眼(0%)。B 组整体分级优于 A 组(P=0.013)。

结论：干态生物羊膜应用在黔东南地区翼状胬肉手术中可显著减轻患者术后早期刺激症状、改善手术区效果分级，但在降低复发率方面仅显示积极趋势，有待扩大样本量进一步验证。

METHODS: This single-center retrospective cohort study enrolled patients diagnosed with primary nasal pterygium who received treatment at Qiandongnan Aier Eye Hospital from April 2023 to June 2025. All participants had resided locally for at least 5 y. Subjects were divided into two groups by surgical modality. Group A underwent pterygium excision combined with autologous conjunctival-limbal stem cell transplantation; Group B received identical core surgery supplemented with 10 mm×15 mm dehydrated biological amniotic membrane to cover the surgical wound. Preoperative baseline data, postoperative day 1 pain and ocular irritation symptoms, the incidence of postoperative complications, 6-month pterygium recurrence rate, and surgical outcome grading were compared between the two groups.

RESULTS: A total of 60 patients(60 eyes)were included, with 30 patients(30 eyes)assigned to each group. Group A consisted of 18 males and 12 females, with a mean age of 56.57±9.34 y; Group B contained 12 males and 18 females, with a mean age of 55.60±9.23 y. No statistically significant intergroup differences were observed in preoperative gender composition, age, or the length of pterygial corneal invasion(all P>0.05), indicating comparable baseline profiles. On postoperative day 1, painful sensation was recorded in 18 eyes(60%)in Group A and 10 eyes(33%)in Group B(P=0.038). Ocular irritation including foreign body sensation, photophobia, and lacrimation occurred in 17 eyes(57%)in Group A versus 5 eyes(17%)in Group B(P=0.001), indicating statistically significance. Regarding short-term postoperative complications: conjunctival hyperemia was noted in 11 eyes of Group A and 7 eyes of Group B on postoperative day 10(P=0.260); conjunctival granulomas developed in 3 eyes of Group A within 1 mo postoperatively, whereas no such lesions appeared in Group B(P=0.237). At the 6-month follow-up, pterygium recurrence was identified in 4 eyes(13%)of Group A, while no recurrence was detected in Group B(P=0.112), with no significant intergroup difference. At 6 mo postoperatively, the surgical outcome grading distribution was as follows: in Group A, Grade 1 was observed in 9 eyes(30%), Grade 2 in 11 eyes(37%), Grade 3 in 6 eyes(20%), and Grade 4 in 4 eyes(13%); in Group B, Grade 1 was observed in 15 eyes(50%), Grade 2 in 14 eyes(47%), Grade 3 in 1 eye(3%), and Grade 4 in 0 eyes(0%). Group B achieved superior overall grading results compared with Group A(P=0.013).

CONCLUSION:For patients in Qiandongnan region, intraoperative application of dehydrated biological amniotic membrane can markedly alleviate early postoperative ocular irritation and improve surgical outcome grading. Nevertheless, this adjunct material only yields a favorable trend in reducing recurrence risk; further studies with expanded sample sizes are required for verification.