自体角膜缘结膜移植术与球结膜瓣转位术治疗翼状胬肉的疗效对比  

Comparison of efficacy of limbal conjunctival autograft and conjunctival flap transposition in the treatment of pterygium

作　　者：刘琳 曹天龙 刘观华 LIU Lin;CAO Tianlong;LIU Guanhua(The first people's Hospital of Suzhou,Suzhou 234000,China)

机构地区：[1]安徽省宿州市第一人民医院眼科,宿州234000

出　　处：《中国中医眼科杂志》2021年第10期703-707,共5页China Journal of Chinese Ophthalmology

摘　　要：目的对比逆行切除+自体角膜缘结膜移植术与逆行切除+球结膜瓣转位术治疗翼状胬肉的疗效。方法选取2018年6月—2019年10月收治的翼状胬肉患者68例(68只眼),采用随机数字表法分为A组和B组,每组34例(34只眼)。A组采用逆行切除+自体角膜缘结膜移植术进行治疗,B组采用逆行切除+球结膜瓣转位术进行治疗。对比2组患者手术时间、角膜上皮愈合时间、临床疗效以及手术前后角膜散光度和裸眼视力。术后随访6个月,对比2组复发率情况。结果(1)手术时间、角膜上皮愈合时间:A组手术时间长于B组(t=4.824,P=0.000),角膜上皮愈合时间短于B组(t=2.023,P=0.047),差异均有统计学意义。(2)总有效率:A组总有效率(94.12%)高于B组(75.53%),χ^(2)=5.314,P=0.021,差异有统计学意义。(3)角膜散光度:与术前比较,A组(t_(1个月)=18.534,t_(3个月)=27.730,均P=0.000)、B组(t_(1个月)=14.934,t_(3个月)=27.218,均P=0.000)术后1、3个月散光度均降低;与术后1个月比较,术后3个月2组散光度均降低(t_(A组)=12.513,t_(B组)=12.376,均P=0.000)。A组术后1、3个月角膜散光度均低于B组,差异均具有统计学意义(t_(1个月)=3.215,P=0.002;t_(3个月)=2.263,P=0.027)。(4)裸眼视力:与术前比较,A组(t_(1个月)=4.852,t_(3个月)=13.908,均P=0.000)、B组(t_(1个月)=2.062,P=0.047;t_(3个月)=9.277,P=0.000)术后1、3个月视力均提高;与术后1个月比较,术后3个月2组视力均提高(t_(A组)=11.662,t_(B组)=7.215,均P=0.000)。A组术后1、3个月视力均高于B组,差异具有统计学意义(t_(1个月)=3.092,P=0.003;t_(3个月)=6.997,P=0.000)。(5)复发率:A组复发率(2.94%)低于B组(23.53%),χ^(2)=4.610,P=0.032,差异有统计学意义。结论通过逆行切除+自体角膜缘结膜移植术治疗翼状胬肉可缩短角膜上皮愈合时间,增强疗效,降低患者角膜散光度,提高裸眼视力,有效降低复发率,治疗效果优于逆行切除+球结膜瓣转位术。OBJECTIVE To compare the effect of retrograde resection combined with limbal conjunctival autograft and retrograde resection combined with conjunctival flap transposition in the treatment of pterygium.METHODS Sixty-eight patients with pterygium admitted to our hospital from June 2018 to October 2019 were randomly divided into group A and group B with 34 cases in each group.Group A was treated with retrograde resection and limbal conjunctival autograft,group B with retrograde resection and conjunctival flap transposition.The duration of operation and corneal epithelial healing time,clinical effect of the two groups were compared.The changes of corneal astigmatism and naked eye vision were compared before operation,one month after operation and three months after operation.Followed up lasted half a year after operation,the recurrence rate of the two groups was compared.RESULTS(1)Duration of operation and corneal epithelial healing time:The operation time in group A was longer than that in group B(t=4.824,P=0.000),and corneal epithelial healing time was shorter(t=2.023,P=0.047),with statistically significant differences.(2)Total effective rate:The total effective rate in group A(94.12%)was higher than that of in group B(75.53%),with a statistically significant difference(χ^(2)=5.314,P=0.021).(3)Corneal astigmatism:Compared with results before operation,the corneal astigmatism in group A and group B after operation decreased with statistically significant differences(group A:t_(1 month)=18.534,P=0.000;t_(3 months)=27.730,P=0.000;group B:t_(1 month)=14.934,P=0.000;t_(3 months)=27.218,P=0.000).Compared with results in one month after operation,the corneal astigmatism in group A and group B decreased in three months after surgery with statistically significant differences(t_(group A)=12.513,P=0.000;t_(group B)=12.376,P=0.000).The corneal astigmatism data in group A in one and three months after operation were both lower than those in group B with statistically significant differences(t_(1 month)=3.215,P=0.002;t_(3 mont

关 键 词：逆行切除 自体角膜缘结膜移植术 球结膜瓣转位术 翼状胬肉 

分 类 号：R777.33[医药卫生—眼科]