胬肉切除联合自体角膜缘干细胞移植治疗翼状胬肉的远期效果及眼表情况  

Long-term Efficacy and Ocular Surface of Pterygium Excision Combined with Autologous Corneal Limbal Stem Cell Transplantation in Treatment of Pterygium

作　　者：王夏虹[1] 陈集玲[1] 

机构地区：[1]厦门大学附属中山医院眼科,中国厦门361004

出　　处：《Eye Science》2015年第3期101-105,共5页眼科学报（英文版）

摘　　要：目的：探讨胬肉切除联合自体角膜缘干细胞移植治疗翼状胬肉的远期效果。方法：2003年12月-2008年12月在我院就诊的原发性翼状胬肉患者55例57眼．均采用胬肉切除联合自体角膜缘干细胞移植治疗，术后随访2-8年，平均5．3年。观察创面愈合隋况、治疗效果和并发症情况。结果：术后早期患者均有不同程度的充血、水肿和异物感，3～5d后症状逐渐减轻，一周左右完全消失。角膜创面完全上皮化时间为4—7d，平均4．83d。术后有持续性眼表刺激症状者7例。术后残留纤维组织者1例，角膜浅层瘢痕者4例。术后随访2-8年，平均5．3年，复发8例8眼（复发率13．11％）。术后1年时复查OSDI评分，所有患者较术前评分均有不同程度的降低，与术前相比，两组评分和构成比差异有统计学意义（P〈0．05）。术后5年时复查OSDI评分较1年前稍有降低，但差异没有统计学意义（P〉0．05）。术后1、5年时泪液基础分泌[（12．95±4．03）min，（12．68±4．77）mm]和泪膜破裂时间[（10．55±4．13）s，（10．03±4．64）s]较术前[（9．48±3．34）mm，（8．14±3．57）s]明显改善，差异有统计学意义（P〈0．05）。结论：应用胬肉切除联合自体角膜缘干细胞移植治疗翼状胬肉，术后早期症状轻、消失快，远期复发少，效果良好。Purpose： To evaluate the long-term efficacy of pterygium excision combined with autologous corneal limbal stem cell transplantation in the treatment of pterygium. Methods： Fifty five patients （57 eyes） diagnosed with primary pterygium undergoing pterygium excision combined with autologous corneal limbal stem cell transplantation between December 2003 and December 2008 were enrolled in this study. Postoperative follow-up endured for 2-8 years, 5.3 years on average. The wound healing, clinical efficacy and postoperative complications were observed. Results： During early stage after surgery, all patients presented with varying degree of hyperemia, edema and sense of foreign body, which were gradually mitigated 3-5 d later and completely recovered in ap- proximately 1 week. The corneal wound was completely epithelized within 4-7 d, 4.83 d on average. Seven patients had persistent ocular surface irritation symptoms after surgery, one case had residual fibrous tissues and four patients developed superficial corneal scars. Postoperative follow-up endured for 2-8 years, 5.3 years on average. Eight patients （8 eyes） recurred with a recurrence rate of 13.11%. In all patients, postoperative OSDI score was significantly decreased at 1-year reexamination. OSDI score and constitution ratio significantly differed between two groups （both P〈0.05）. At postoperative 5 years, OSDI score was slightly lower compared with that in last year with no statistical significance（P〉0.05）. At post-operative 1- and 5-year, basic tear secretion was （12.95±4.03） mm and （12.68±4.77） mm, tear film break-up time was （10.55±4.13） s and （10.03±4.64） s. Both indexes were significantly improved compared with （9.48±3.34） mm and （8.14±3.57） s before surgery （all P〈0.05）. Conclusion ：Pterygium excision combined with autologous corneal limbal stem cell transplantation is an efficacious treatment of pterygium with mild postoperative symptoms, rapid recovery, low long-term recurrence rate and hig

关 键 词：翼状胬肉 显微手术 自体角膜缘干细胞移植 远期效果 

分 类 号：R779.6[医药卫生—眼科]