翼状胬肉切除联合羊膜移植术加绷带镜术后角膜上皮修复时间及复发率研究  

Study of corneal epithelium healing time and recurrence rate after pterygium excision combined with amniotic membrane transplantation and bandage lens

作　　者：谢平[1] 何静[1] 欧阳君[1] 

机构地区：[1]江西省九江市第一人民医院眼科,江西九江332000

出　　处：《中国当代医药》2015年第35期94-96,共3页China Modern Medicine

基　　金：江西省卫生厅科技计划(20154018)

摘　　要：目的研究翼状胬肉切除联合羊膜移植术加绷带镜术后角膜上皮修复时间及复发率。方法选取2013年1月-2015年1月在九江市第一人民医院就诊的210例双眼翼状胬肉患者,其胬肉位于鼻侧,长入角膜3-5 mm的初发胬肉。双眼行翼状胬肉切除联合羊膜移植术,术后随机选取1只眼为A组,另1只眼为B组。A组（210只眼）单纯手术;B组（210只眼）术后佩戴角膜绷带镜。观察记录双眼术后1、3、5、7、15 d角膜上皮修复情况及眼痛;OCT检查角膜上皮修复时间,采用视觉模拟评分法（VAS）评价角膜上皮愈合情况,通过荧光素染色确认愈合;术后1、3、6个月复查,之后半年一复查,随访观察疗效及复发。结果 B组术后1、3、5、7 d的疼痛值平均值均低于A组（P〈0.01）;B组术后3、5、7 d角膜修复均较A组快,差异有统计学意义（P〈0.01）;术后随访,两组复发率差异无统计学意义（P〉0.05）。结论翼状胬肉切除联合羊膜移植术加绷带镜术后角膜修复时间短,眼痛症状轻,术后复发率低。Objective To study corneal epithelial healing time and recurrence rate after pterygium excision combined with amniotic membrane transplantation and bandage lens. Methods From January 2013 to January 2015,210 patients with pterygium in double eyes visited our hospital were selected.The pterygium was located beside nose,and deepened into the cornea for 3 to 5 mm as primary pterygium.The pterygium excision combined with amniotic membrane transplantation was carried out for double eyes.After surgery,one eye was randomly selected into group A and the other one was divided into group B.In group A（210 eyes）,only surgery was used,and in group B（210 eyes）,corneal contact lens was worn after surgery.The healing time of corneal epithelium and ophthalmodynia were observed and recorded 1,3,5,7,15 days after surgery.The healing time of corneal epithelium by OCT examination was comparatively studied.The pain value was evaluated by visual analogue score（VAS）.The healing status of corneal epithelium was evaluated and finally confirmed by fluorescent staining.Reexaminations were necessary 1,3,6 months after surgery,after that,half a year for once.The effect and recurrence were observed after 2 years follow up visits. Results The average pain values 1,3,5,7days after surgery in group B was lower than that in group A respectively（P〈0.01）.The corneal healing was faster 3,5,7days after surgery in group B than that in group A respectively,with statistical difference（P〈0.01）.Follow up visits after surgery,recurrence rate in group A and group B was no statistical difference（P〈0.05）. Conclusion Pterygium excision combined with amniotic membrane transplantation and bandage lens has advantages of short time of corneal healing after surgery,slight ophthalmodynia,and low postoperative recurrence rate.

关 键 词：翼状胬肉 羊膜移植 角膜绷带镜 

分 类 号：R777.33[医药卫生—眼科]