丝裂霉素C联合自体游离结膜瓣移植治疗翼状胬肉的临床观察  

Clinical observations of conjunctival autografting combined with mitomycin C in treatment of pterygium

作　　者：李佳[1] 周丹虹[1] 陆琳娜[2] 

机构地区：[1]无锡市第四人民医院眼科,无锡214062 [2]上海交通大学医学院附属第九人民医院眼科,上海200011

出　　处：《上海交通大学学报（医学版）》2011年第8期1102-1104,共3页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市重点学科建设项目(S30205)~~

摘　　要：目的探讨翼状胬肉切除并自体游离结膜瓣移植联合丝裂霉素C(MMC)治疗翼状胬肉后出现并发症的原因、治疗及预防。方法对139例翼状胬肉患者(153眼)行翼状胬肉切除联合自体结膜瓣移植,术中MMC(0.2 mg/mL)棉片于巩膜面湿敷2 m in,随访1年,对术后并发症进行分析。结果胬肉复发6眼(3.92%);结膜创口延迟愈合11眼(7.19%)及浅层点状角膜炎9眼(5.88%),未予特殊治疗;结膜瓣溶解7眼(4.58%)、巩膜无血管化2眼(1.31%)及继发青光眼1眼(0.65%),局部药物治疗有效;结膜肉芽肿2眼(1.31%)及角巩膜溶解患者2眼(1.31%),联合手术治疗。结论联合丝裂霉素C治疗翼状胬肉可降低胬肉复发,但同时可能造成角巩膜溶解等并发症。应术前排除免疫性疾病史,术中注意敷贴放置位置,术后注重随访,以减少并发症发生。Objective To observe the clinical outcomes of pterygium excision with mitomycin C combined with conjunctival autografting in treatment of pterygium. Methods A total of 139 patients(153 eyes) with pterygium undergoing pterygium excision were treated with conjunctival autograft combined with mitomycin C(0.2 mg/mL,wet packing on sclera for 2 min).All patients were followed up for 1 year,and postoperative complications were assessed. Results Pterygium recurred in 6 eyes(3.92%).Delayed conjunctival wound healing took place in 11 eyes(7.19%),superficial punctate keratitis occurred in 9 eyes(5.88%),and no special treatment was conducted.Conjunctival flap melting took place in 7 eyes(4.58%),sclera without vascularization occurred in 2 eyes(1.31%),glaucoma happened in 1 eye(0.65%),and topical treatment with drugs were effective.Conjunctival granuloma took place in 2 eyes(1.31%),corneoscleral melting occurred in 2 eyes(1.31%),and topical treatment with drugs and surgery were adopted. Conclusion Conjunctival autografting combined with mitomycin C in pterygium excision may decrease the recurrence of pterygium,but may lead to the complications such as corneoscleral melting.Exclusion of immunological diseases before operation,proper wet packing during operation and regular follow-up after operation can reduce the occurrence of complications.

关 键 词：翼状胬肉 丝裂霉素C 游离结膜瓣移植 并发症 

分 类 号：R779.6[医药卫生—眼科]