湿态羊膜覆盖术与角膜绷带镜治疗巨大翼状胬肉的临床疗效研究  

Clinical Efficacy of Hydrated Amniotic Membrane Covering and Corneal Bandage Lens in the Treatment of Huge Pterygium

作　　者：庞宇 付馨余[1] 张俊强 喻谦[1] Pang Yu;Fu Xinyu;Zhang Junqiang;Yu Qian(Department of Ophthalmology,The First Affiliated Hospital of Chengdu Medical College,Chengdu 610500,China)

机构地区：[1]成都医学院第一附属医院眼科,成都610500

出　　处：《成都医学院学报》2021年第6期755-758,共4页Journal of Chengdu Medical College

摘　　要：目的探究巨大翼状胬肉切除联合角膜缘干细胞移植术后应用湿态羊膜和角膜绷带镜的临床疗效差异。方法选取2020年1月至2021年1月于成都医学院第一附属医院眼科确诊的17例初发性巨大翼状胬肉患者作为研究对象,按照手术方式分为羊膜覆盖组(n=8)和角膜绷带镜组(n=9)。两组均接受巨大胬肉切除联合角膜缘干细胞移植术,羊膜覆盖组术后应用湿态羊膜覆盖术,角膜绷带镜组术后应用角膜绷带镜,比较两组术后疼痛情况、裸眼视力、角膜地形图表面不对称指数、角膜散光度及术后瘢痕化情况。结果术后3个月,两组裸眼视力较术前均有提高(P<0.05);两组角膜散光度及角膜地形图表面不对称指数均较术前下降(P<0.05)。术后3个月,羊膜覆盖组裸眼视力明显优于角膜绷带镜组(P<0.05),角膜散光度及角膜地形图表面不对称指数较角膜绷带镜组下降更明显(P<0.05)。术后当天及术后第1、2、7天,两组疼痛评分比较差异无统计学意义(P>0.05)。术后3个月,两组角膜瘢痕化比较,差异无统计学意义(P>0.05)。结论湿态羊膜覆盖联合角膜缘干细胞移植术治疗巨大翼状胬肉,可明显改善患者术后角膜屈光状态和视力情况。Objective To explore the difference of clinical efficacy between hydrated amniotic membrane and corneal bandage lens after huge pterygium excision combined with conjunctival limbal autograft. Methods A total of 17 patients with primary huge pterygium treated in the ophthalmology department of the First Affiliated Hospital of Chengdu Medical College from January 2020 to January 2021 were selected. They were divided into hydrated amniotic membrane covering group(n=8) and corneal bandage lens group(n=9) according to the surgical way. All patients underwent huge pterygium excision combined with conjunctival limbal autograft. After surgery, hydrated amniotic membrane covering was applied in the hydrated amniotic membrane covering group, while corneal bandage lens was used in the corneal bandage lens group. Postoperative pain, naked visual acuity, corneal topography surface asymmetry index, corneal astigmatism and postoperative scarring were compared between the two groups. Results Compared with those before surgery, naked visual acuity was improved(P<0.05), corneal astigmatism and corneal topography surface asymmetry index decreased(P<0.05) in both groups 3 months after surgery. And the hydrated amniotic membrane covering group had better naked visual acuity(P<0.05) and lower corneal astigmatism and corneal topography surface asymmetry index(P<0.05) than corneal bandage lens group 3 months after surgery. There was no significant difference in postoperative pain scores between the two groups on the day of surgery and on the 1 st, 2 nd and 7 th day after surgery(P>0.05). Three months after operation, There was no significant difference in postoperative corneal scarring between the groups(P>0.05). Conclusion Hydrated amniotic membrane covering combined with conjunctival limbal autograft in the treatment of huge pterygium can significantly improve the postoperative corneal refractive state and visual acuity.

关 键 词：巨大翼状胬肉 生物羊膜 角膜绷带镜 角膜缘干细胞移植 

分 类 号：R779.6[医药卫生—眼科]