复发翼状胬肉显微切除联合羊膜及自体角膜缘移植临床分析  

Outcome of microsurgery for recurrent pterygium using amniotic membrane and limbal autograft transplantation

作　　者：奚翠萍[1] 柯敏[1] 蔡小军[1] 

机构地区：[1]武汉大学中南医院眼科,武汉430071

出　　处：《中国实用眼科杂志》2007年第11期1211-1213,共3页Chinese Journal of Practical Ophthalmology

基　　金：湖北省科技攻关项目（编号：301130986）

摘　　要：目的比较显微镜下胬肉切除羊膜移植术（Amniotic membrane transplantation,AMT）与联合羊膜移植＋自体带结膜的角膜缘移植术（Limbal autograft transplantation,LAT）治疗复发性翼状胬肉手术效果。方法将2003年5月至2005年9月就诊的80例103眼复发性翼状胬肉患者按就诊顺序编号后,按随机数字表的方法分为两组。AMT组：40例52眼完成常规胬肉切除术后,联合AMT手术;联合AMT＋LAT组：40例51眼完成常规胬肉切除术后,先行羊膜移植术,再联合带结膜的自体角膜缘组织移植。结果①AMT组,平均随访（14.6±2.4）月,12眼复发,复发率23.08%;52眼中合并有睑球粘连、眼球运动障碍18眼,随访期间12眼睑球粘连获得解除,眼球运动障碍消失;6眼改善。②联合AMT＋LAT组,平均随访（15.4±1.4）月,4眼复发,复发率7.84%;51眼中合并有睑球粘连、球运动障碍19眼,随访期间14眼睑球粘连获得解除,眼球运动障碍消失;5眼改善。两组比较差异有统计学意义（P〈0.05）。结论在显微镜下采用显微技术操作联合AMT＋LAT治疗复发胬肉可降低复发率,减少并发症。Objective To compare the clinical outcome of recurrent pterygium microsurgery combining amniotic membrane transplantation （AMT） with combining amniotic membrane and limbal autograft transplantation （AMT＋LAT） . Methods Eighty patients with recurrent pterygium from May 2003 to September 2005 were divided randomly into 2 groups. In group 1（ 52 eyes of 40 patients） underwent simple excision combining amniotic membrane transplantation （AMT） technique. In group 2 （51 eyes of 40 patients） were treated by simple excision combining amniotic membrane and limbal autograff transplantation （AMT＋LAT） . Results The recurrence rate of group 1 was 23.08%（12eyes ,mean follow up 14.6 ± 2.4months）; During the follow-up time ,18 eyes of 30 patients associated with symblepharon and ocular motility restriction had 12 cases symblepharon removed,movement of eyeballs recovered and 6 cases ameliorated. The recurrence rate of group 2 was 7.84% （4eyes,mean follow upl5.4 ± 1.4months）. During the follow-up time 19 eyes of 30 patients associated with symblepharon and ocular motility restriction had 14 cases symblepharon removed,movement of eyeballs recovered and 5 cases ameliorated. Conclusion The simple excision combining AMT＋LAT technique under microscope is an effective surgery for the treatment of recurrent pterygium. It can decrease the recurrence rate and reduce postoperative complications.

关 键 词：翼状胬 移植术 显微外科手术 

分 类 号：R777.33[医药卫生—眼科]