不同手术方案治疗白内障合并翼状胬肉的临床疗效  

Clinical effects of different surgical treatments for cataract with pterygium

作　　者：陈桂芬 杨建华 李明新 CHEN Gui-fen;YANG Jian-hua;LI Ming-xin(Department of Ophthalmology,1.the Affiliated Hospital of Xuzhou Medical University;Xuzhou Fuxing Eye Hospital,Xuzhou 221000,Jiangsu,China)

机构地区：[1]徐州医科大学附属医院眼科 [2]徐州复兴眼科医院眼科,江苏徐州221000

出　　处：《川北医学院学报》2022年第11期1467-1471,共5页Journal of North Sichuan Medical College

摘　　要：目的:比较不同手术方案治疗白内障合并翼状胬肉的临床效果。方法:选取190例白内障合并翼状胬肉患者为研究对象,按照手术方案不同分为A组和B组,每组各95例。A组患者先行白内障超声乳化吸出(PHACO)+人工晶状体(IOL)植入术,再择期行翼状胬肉切除+改良角膜缘干细胞移植术;B组患者先行翼状胬肉切除+改良角膜缘干细胞移植术,再择期行PHACO+IOL植入术治疗。第2次手术均在第1次手术后恢复3~6个月进行。治疗后6个月,比较两组患者视力[裸眼近视力(UNVA)、裸眼远视力(UDVA)及最佳矫正视力(BCVA)]及屈光度(实际数值及偏倚)、客观视觉质量[客观散射指数(OSI)、调制传递函数截止频率(MTF cut off)、斯特列尔比值(SR)、对比度为100%、20%及9%时的模拟对比度视力(OV)]、主观视觉质量[屈光不正生活质量量表(NEI-RQL-42)评分]、干眼症评分及随访期间并发症和复发情况。结果:治疗后,两组患者UNVA、UDVA及BCVA均升高(P<0.05),且B组UNVA、UDVA高于A组(P<0.05);B组患者OSI、屈光度实际数值及偏倚低于A组(P<0.05),MTF cut off、SR、OV100%、OV20%及OV9%及NEI-RQL-42量表各维度评分均高于A组(P<0.05)。两组患者干眼症评分、并发症及复发情况比较,差异无统计学意义(P>0.05)。结论:先行翼状胬肉切除术+改良角膜缘干细胞移植术,再择期行PHACO+IOL植入术治疗白内障合并翼状胬肉的临床效果较好,可提升患者裸眼视力及视觉质量。Objective:To compare the clinical effect of different surgical treatment of cataract with pterygium.Methods: A total of 190 patients with cataract and pterygium were selected as the research objects.According to the different surgical methods, the patients were divided into group A and group B,95 cases in each group.The two groups were required to undergo a second operation within 3~6 months after the first operation.Group A:first phacoemulsification(PHACO)+intraocular lens(IOL) implantation, and then elective pterygium excision+modified limbal stem cell transplantation.Group B:First pterygium excision+ modified limbal stem cell transplantation, and then elective PHACO+IOL implantation.The second operation was performed 3~6 months after the first operation.After 6 months of treatment, the changes of visual acuity [near visual acuity(UNVA),far visual acuity(UDVA) and best corrected visual acuity(BCVA)],diopter(actual value and bias),objective visual quality [objective scattering index(OSI),modulation transfer function cut off(MTF cut off),Strehl ratio(SR),simulated contrast visual acuity(OV) at 100 %,20 % and 9 % contrast],subjective visual quality [ametropia quality of life scale(NEI-RQL-42)],xerophthalmia, and complications and recurrence during follow-up were compared between the two groups.Results:After treatment, the UNVA,UDVA and BCVA of the two groups increased(P<0.05),the UNVA and UDVA in group B were higher than those in group A(P<0.05).The OSI and actual value of diopter in group B were lower than those in group A(P<0.05),and MTF cut off, SR, OV100 %,OV20 %,OV9 %,and the scores of NEI-RQL-42 scale in group B were higher than those of group A(P<0.05).There was no significant difference in xerophthalmia score, complications and recurrence between the two groups(P>0.05).Conclusion:The clinical effect of pterygium excision combined with modified limbal stem cell transplantation and PHACO+IOL implantation in the treatment of cataract with pterygium is better, which can significantly improve the naked eye visi

关 键 词：白内障 翼状胬肉 白内障超声乳化吸出 翼状胬肉切除 视力 

分 类 号：R779.6[医药卫生—眼科]