中华眼外伤职业眼病杂志
中華眼外傷職業眼病雜誌
중화안외상직업안병잡지
CHINESE JOURNAL OF OCULAR TRAUMA AND OCCUPATIONAL EYE DISEASE
2013年
7期
493-496
,共4页
李良毛%赵立全%瞿玲辉%李鹏
李良毛%趙立全%瞿玲輝%李鵬
리량모%조립전%구령휘%리붕
准分子激光角膜切削术,治疗性%翼状胬肉%干细胞,角膜缘
準分子激光角膜切削術,治療性%翼狀胬肉%榦細胞,角膜緣
준분자격광각막절삭술,치료성%익상노육%간세포,각막연
Keratectomy,phototherapeutic%Pterygium%Stem cell,limbal
目的 探讨准分子激光治疗性角膜切削术(PTK)治疗复发性翼状胬肉的临床疗效.方法 回顾性对照分析106例(106眼)复发性翼状胬肉.PTK治疗组53例:分离、切除胬肉及变性筋膜组织,用193 nm准分子激光行PTK切削残余的角膜病变组织.对照组53例:进行自体角膜缘干细胞移植术.观察术后上皮愈合情况,记录角膜散光度及胬肉复发情况.结果 PTK组术后平均上皮愈合时间为(3.96±0.78)d,较对照组的(4.67 ±1.01)d显著缩短(t=-4.071,P＜0.01)；PTK组术后角膜散光度数较术前减少(0.72±0.80)d,较对照组(0.42±0.43)d显著改善(t=-1.342,P=0.02).平均随访(18.05±5.32)月,PTK组3例胬肉复发,复发率为5.66％,对照组4例胬肉复发,复发率为7.55％,两组相比差异无统计学意义(x2=0.368,P=0.70).结论 PTK治疗复发性翼状胬肉,可以安全、有效地清除残留胬肉及变性组织,减少手术创面,利于角膜上皮修复.取得与自体角膜缘干细胞移植术同样的治愈率.
目的 探討準分子激光治療性角膜切削術(PTK)治療複髮性翼狀胬肉的臨床療效.方法 迴顧性對照分析106例(106眼)複髮性翼狀胬肉.PTK治療組53例:分離、切除胬肉及變性觔膜組織,用193 nm準分子激光行PTK切削殘餘的角膜病變組織.對照組53例:進行自體角膜緣榦細胞移植術.觀察術後上皮愈閤情況,記錄角膜散光度及胬肉複髮情況.結果 PTK組術後平均上皮愈閤時間為(3.96±0.78)d,較對照組的(4.67 ±1.01)d顯著縮短(t=-4.071,P＜0.01)；PTK組術後角膜散光度數較術前減少(0.72±0.80)d,較對照組(0.42±0.43)d顯著改善(t=-1.342,P=0.02).平均隨訪(18.05±5.32)月,PTK組3例胬肉複髮,複髮率為5.66％,對照組4例胬肉複髮,複髮率為7.55％,兩組相比差異無統計學意義(x2=0.368,P=0.70).結論 PTK治療複髮性翼狀胬肉,可以安全、有效地清除殘留胬肉及變性組織,減少手術創麵,利于角膜上皮脩複.取得與自體角膜緣榦細胞移植術同樣的治愈率.
목적 탐토준분자격광치료성각막절삭술(PTK)치료복발성익상노육적림상료효.방법 회고성대조분석106례(106안)복발성익상노육.PTK치료조53례:분리、절제노육급변성근막조직,용193 nm준분자격광행PTK절삭잔여적각막병변조직.대조조53례:진행자체각막연간세포이식술.관찰술후상피유합정황,기록각막산광도급노육복발정황.결과 PTK조술후평균상피유합시간위(3.96±0.78)d,교대조조적(4.67 ±1.01)d현저축단(t=-4.071,P＜0.01)；PTK조술후각막산광도수교술전감소(0.72±0.80)d,교대조조(0.42±0.43)d현저개선(t=-1.342,P=0.02).평균수방(18.05±5.32)월,PTK조3례노육복발,복발솔위5.66％,대조조4례노육복발,복발솔위7.55％,량조상비차이무통계학의의(x2=0.368,P=0.70).결론 PTK치료복발성익상노육,가이안전、유효지청제잔류노육급변성조직,감소수술창면,리우각막상피수복.취득여자체각막연간세포이식술동양적치유솔.
Objective To evaluate the treatment outcomes of excimer laser phototherapeutic keratectomy (PTK) for recurrent pterygium.Methods 106 eyes of 106 patients diagnosed with recurrent pterygium that underwent PTK or autologous limbal stem cell transplantation were retrospectively evaluated.PTK treatment group (53 eyes):Pterygia were treated by separating and excising conjunctiva and pathological tissues.The residual pathological tissues underwent PTK with the Technolas 217z excimer laser.Control group (53 eyes):autologous limbal stem cell transplantation was performed.Data were analyzed for preoperative and postoperative reepitheliation,recurrence rate,and corneal astigmatism.Results The mean reepitheliation time of PTK group was (3.96 ± 0.78) days,and it was significantly shorter than that of control group (4.67 ± 1.01) days (t =-4.071,P ＜ 0.01).The mean postoperative corneal astigmatism in PTK group declined about (0.72 ± 0.80) D comparing to the preoperative one,and the improvement was signifi-cantly more than that of the control group (0.42 ± 0.43 D) (t =-1.342,P =0.02).The mean follow-up time was (18.05 ± 5.32) months.3 cases recurred in PTK group,the recurrence rate was 5.66％ ; 4 cases recurred in control group,the recurrence rate was 7.55％.There was no significant difference in recurrent rate between the two groups (x2 =0.368,P =0.70).Conclusion PTK can be a safe and effective therapeutic alternative for recurrent pterygium.It can avoid excessive operative trauma,hasten reepitheliation,and reduce corneal astigmastism.It can effectively decrease the recurrence rate of pterygium as autologous limbal stem cell transplantation.
