翼状胬肉切除术式对术后眼表修复的影响  

Effects of different pterygium surgical methods on ocular surface repairment

作　　者：贾烨[1] 赖兆光[2] 

机构地区：[1]钟祥市人民医院眼科,湖北省钟祥市431900 [2]广西壮族自治区人民医院眼科赖兆光,广西南宁市530021

出　　处：《眼科新进展》2013年第1期80-82,共3页Recent Advances in Ophthalmology

摘　　要：目的观察比较翼状胬肉不同手术方式对术后眼表修复的影响。方法选择2009年10月至2011年4月于我院行翼状胬肉切除术的单眼鼻侧原发性翼状胬肉患者,根据术前3d泪膜破裂时间(break-up time,BUT)、泪液分泌试验I(SchirmerI test,SIt)、结膜印迹细胞学检查结果,筛选出三项指标均异常患者96例(96眼),随机分为3组,分别接受单纯翼状胬肉切除术(A组)、翼状胬肉切除联合结膜瓣转移术(B组)及翼状胬肉切除联合自体角膜缘干细胞移植术(C组),另选择三项指标均正常的患者25例(25眼),行翼状胬肉切除联合自体角膜缘干细胞移植术(D组)。术后3个月行BUT、SIt、结膜印迹细胞学检查,对测量结果进行统计学分析。结果 A组、B组、C组术后3个月BUT分别为(9.8±1.5)s、(9.6±1.9)s和(10.2±1.5)s,与术前(6.7±1.3)s、(6.2±1.0)s、(6.6±1.3)s相比,差异均有统计学意义(均为P<0.05);D组术后3个月BUT为(13.8±1.1)s,与术前(14.1±1.0)s相比,差异无统计学意义(P>0.05)。A组、B组、C组术后3个月SIt、结膜杯状细胞计数较术前提高或增加,差异均有统计学意义(均为P<0.05);D组术前SIt、结膜杯状细胞计数与术后3个月比较,差异均无统计学意义(均为P>0.05)。结论翼状胬肉切除对眼表损伤有修复作用,翼状胬肉切除联合自体角膜缘干细胞移植术后眼表损伤的修复作用较好。Objective To observe the effects of different procedures of pterygi- um surgery on postoperative ocular surface repairment. Methods The patients with nasal primary pterygium underwent pterygium excision in our hospital from October, 2009 to April,2011 were enrolled, and based on the tear film break-up time （BUT）, Schirmer test I （Sit） and conjunctival impression cytology at preoperative 3 days ,96 ca- ses （95 eyes） with abnormal indexes were screened and randomly divided into 3 groups： Group A （ 32 patients） received pterygium excision, group B （ 32 patients） re- ceived pterygium excision combined with conjunctival flap autograft, group C （ 32 pa- tients） received pterygium excision combined with serf-corneal limbus stem cell trans- plantation. Another 25 cases （25 eyes） with normal indexes were chosen as group D, and pterygium excision combined with serf-corneal limbus stem cell transplantation was performed. BUT, Sit and conjunctival impression cytology were performed at postopera- tive 3 months and compared between groups using statistical analysis. Results BUT at postoperative 3 months in group A, B, C were （9.8±1.5 ） s, （9.6±1.9） s and （ 10.2±1.5 ） s, respectively, compared with pre-operation （ 6.7±1.3 ） s, （ 6.2±1.0） s and （ 6.6±1.3 ） s, there were statistical differences （ all P 〈 0.05 ）. BUT at postoperative 3 months in group D was （ 13.8 ±1.1 ） s, compared with pre-operation （ 14.1±1.0） s, there was no statistical difference （P 〉 0.05 ）. The similarly results were observed in Sit and con- junctival goblet cells counting in four groups. Conclusion Pterygium surgery can re-pmr the conconutant ocular sureace injury oi pterygium, Compared with other surgical procedures, pterygium excision com- bined with serf-corneal limbus stem cell transolantation has a better effect.

关 键 词：翼状胬肉 泪膜破裂时间 泪液分泌试验 结膜印迹细胞学 

分 类 号：R777.33[医药卫生—眼科]