中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2013年
12期
751-754
,共4页
翼状胬肉%丝裂霉素%自体角膜缘结膜移植
翼狀胬肉%絲裂黴素%自體角膜緣結膜移植
익상노육%사렬매소%자체각막연결막이식
Pterygium%Mitomycin%Limbal conjunctival autograft
目的 探讨术中局部使用丝裂霉素C贴敷能否进一步提高自体角膜缘结膜移植术治疗原发及复发翼状胬肉的效果.方法 将2005年至2009年在天津医科大学总医院眼科门诊确诊为翼状胬肉的114例患者(134眼)按随机数字表法分为A、B2组.A组59例70眼(原发63眼,复发7眼),采用翼状胬肉切除联合自体角膜缘结膜移植术,并于术中局部使用0.02％丝裂霉素C;B组55例64眼(原发57眼,复发7眼),采用同样手术方法,但术中不使用丝裂霉素C.比较2组术后角膜上皮生长情况、翼状胬肉复发率、视力及术后并发症.患者平均随访时间(23.3±8.6)个月(12～65个月).数据采用独立样本t检验和卡方检验.结果 A组病例角膜上皮生长时间平均为(4.0±0.8)d,略长于B组的(3.4±0.6)d(t=-3.71,P＜0.05).2组翼状胬肉复发率均为3％ (x2=0.008,P＞0.05).A组术后视力不变或提高者为74％,B组为65％(x2=1.301,P＞0.05).术后并发症主要包括角膜上皮延迟愈合,角膜缘结膜植片松脱,角膜缘小凹形成,结膜上皮下囊肿等.A组并发症发生率为6％,B组为5％(x2=0.071,P＞0.05).结论 术中局部应用丝裂霉素C对于自体角膜缘结膜移植术治疗原发及复发翼状胬肉的辅助作用有限,而且可能引起角膜上皮延迟愈合等并发症.
目的 探討術中跼部使用絲裂黴素C貼敷能否進一步提高自體角膜緣結膜移植術治療原髮及複髮翼狀胬肉的效果.方法 將2005年至2009年在天津醫科大學總醫院眼科門診確診為翼狀胬肉的114例患者(134眼)按隨機數字錶法分為A、B2組.A組59例70眼(原髮63眼,複髮7眼),採用翼狀胬肉切除聯閤自體角膜緣結膜移植術,併于術中跼部使用0.02％絲裂黴素C;B組55例64眼(原髮57眼,複髮7眼),採用同樣手術方法,但術中不使用絲裂黴素C.比較2組術後角膜上皮生長情況、翼狀胬肉複髮率、視力及術後併髮癥.患者平均隨訪時間(23.3±8.6)箇月(12～65箇月).數據採用獨立樣本t檢驗和卡方檢驗.結果 A組病例角膜上皮生長時間平均為(4.0±0.8)d,略長于B組的(3.4±0.6)d(t=-3.71,P＜0.05).2組翼狀胬肉複髮率均為3％ (x2=0.008,P＞0.05).A組術後視力不變或提高者為74％,B組為65％(x2=1.301,P＞0.05).術後併髮癥主要包括角膜上皮延遲愈閤,角膜緣結膜植片鬆脫,角膜緣小凹形成,結膜上皮下囊腫等.A組併髮癥髮生率為6％,B組為5％(x2=0.071,P＞0.05).結論 術中跼部應用絲裂黴素C對于自體角膜緣結膜移植術治療原髮及複髮翼狀胬肉的輔助作用有限,而且可能引起角膜上皮延遲愈閤等併髮癥.
목적 탐토술중국부사용사렬매소C첩부능부진일보제고자체각막연결막이식술치료원발급복발익상노육적효과.방법 장2005년지2009년재천진의과대학총의원안과문진학진위익상노육적114례환자(134안)안수궤수자표법분위A、B2조.A조59례70안(원발63안,복발7안),채용익상노육절제연합자체각막연결막이식술,병우술중국부사용0.02％사렬매소C;B조55례64안(원발57안,복발7안),채용동양수술방법,단술중불사용사렬매소C.비교2조술후각막상피생장정황、익상노육복발솔、시력급술후병발증.환자평균수방시간(23.3±8.6)개월(12～65개월).수거채용독립양본t검험화잡방검험.결과 A조병례각막상피생장시간평균위(4.0±0.8)d,략장우B조적(3.4±0.6)d(t=-3.71,P＜0.05).2조익상노육복발솔균위3％ (x2=0.008,P＞0.05).A조술후시력불변혹제고자위74％,B조위65％(x2=1.301,P＞0.05).술후병발증주요포괄각막상피연지유합,각막연결막식편송탈,각막연소요형성,결막상피하낭종등.A조병발증발생솔위6％,B조위5％(x2=0.071,P＞0.05).결론 술중국부응용사렬매소C대우자체각막연결막이식술치료원발급복발익상노육적보조작용유한,이차가능인기각막상피연지유합등병발증.
Objective To determine whether intraoperative mitomycin C (MMC) can enhance the efficacy of limbal conjunctival autograft transplantation (LCAT) for the treatment of primary and recurrent pterygium.Methods This was a prospective case-control study.One hundred and thirty-four eyes of 114 patients with primary and recurrent pterygium were randomly divided into 2 groups.In group A,63 eyes with primary pterygium and 7 eyes with recurrent pterygium were treated with pterygium resection and LCAT combined with a local application of MMC.In group B,57 eyes with primary pterygium and 7 eyes with recurrent pterygium underwent pterygium resection and limbal conjunctival autograft transplantation alone.Epithelial regeneration,rate of pterygium recurrence,visual prognosis and complications were evaluated and compared between the two groups.The mean follow-up was 23.3±8.6 months with a range from 12 to 65 months.Data were analyzed using an independent t test and chi-square test.Results No intraoperative complications were found in any eyes.Postoperative corneal epithelial regeneration took an average of 4.0±0.8 days and 3.4±0.6 days in groups A and B,respectively (t=-3.71,P＞0.05).The rate of pterygium recurrence was 3％ in both groups (x2=0.008,P＞0.05).Postoperative visual acuity improved or remained stable in 74％ of group A and 65％ of group B (x2=1.301,P＞0.05).Postoperative complications included delayed corneal epithelial recovery,limbal conjunctival autograft lag,corneal dellen,and subepithelial inclusion cyst in group A (6％) and group B (5％) (x2=0.071,P＞0.05).Conclusion Intraoperative use of MMC does not enhance the efficacy of LCAT for the treatment of pterygium and may lead to a delay in corneal epithelial recovery.
