两种手术方式治疗翼状胬肉术后泪膜稳定性观察  

Clinical observation of tear film stability on two types of surgical methods for treatment of pterygium

作　　者：岳辉[1] 任秋锦[1] 谷树严[1] 周清[1] 黄晶[1] 

机构地区：[1]长沙市第四医院眼科,长沙410006

出　　处：《中国实用眼科杂志》2012年第7期823-825,共3页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察两种不同手术方式治疗翼状胬肉对术后泪膜质和量的影响。方法选取翼状胬肉患者90例90只眼，随机分为翼状胬肉切除联合羊膜移植组，翼状胬肉切除联合角膜缘干细胞移植组。术后2天，1周，1个月、3个月行泪液分泌（Schirmerl）试验、泪膜破裂时间（breakuptime，BUT），泪液羊齿状物试验（mucusfemtest，MFT），印迹细胞学检查。结果术后两组泪液分泌量，羊齿状结晶物检查差异无统计学意义。冀状胬肉切除联合角膜缘干细胞移植组术后早期泪膜稳定性优于翼状胬肉切除联合羊膜移植组，差异具有统计学意义（P〈0．05）。印迹细胞学检查表明术后两组上皮细胞形态及杯状细胞数量，鳞状上皮化生程度无明显差异。结论翼状胬肉切除联合角膜缘干细胞移植手术治疗翼状胬肉较翼状胬肉切除羊膜移植术后早期可保持良好的泪膜稳定性，患者干眼症状轻。适合术前有干眼症状的翼状胬肉患者。Objective To observe the influence of two surgical methods for treatment of pterygi- um on the quality and quantity of postoperative tear-film. Methods A total of 90 cases （90 eyes） underwent pterygium surgery were divided into 2 groups randomly, group A （pterygium excision with amniotic membrane transplantation） and group B （pterygium excision with limbal stem cell trans- plantation）. Schirmer test, tear break-up time, mucusfemtest, and imprinting cytology were measured 2 days, 1 week, 1 month and 3 months postoperatively. Results There was no statistically signifi- cant difference in the amount of tear secretion and fern crystals inspection between the two groups postoperatively. Tear film stability of group B was better than that of group A at early postopera- tive, which was statistically significant difference （P 〈0.05）. Impression cytology examination showed that the differences in epithelial cells form, goblet cells quantity and squamous metaplasia between the two groups postoperatively. Conclusions Tear film stability of pterygium excision combined with limbal stem cell transplantation is better compared with pterygium excision combined with amni- otic membrane transplantation at early postoperative. Patients bear mild symptoms of dry eye.

关 键 词：翼状胬肉 泪膜 角膜缘干细胞 羊膜移植 

分 类 号：R779.63[医药卫生—眼科]