翼状胬肉转位术联合羊膜移植加绷带型角膜接触镜治疗翼状胬肉
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Effect of pterygium transplantation combined with amniotic membrane transplantation plus bandage contact lenses for pterygium
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    摘要:

    目的:探讨翼状胬肉转位术与羊膜移植加绷带型角膜接触镜治疗翼状胬肉的临床疗效。

    方法:本研究纳入观察对象为2014-12/2016-12于我院治疗的翼状胬肉患者72例80眼,按照治疗方式不同分为两组,对照组35例39眼行翼状胬肉转位术联合羊膜移植治疗,观察组37例41眼在此基础上加用绷带型角膜接触镜治疗; 随访1a,观察术后视力变化,评价手术疗效,比较两组患者术后疗效、复发率以及角膜愈合天数,术前、术后1d,1、3、6、12mo采用非接触式眼压计检测眼压变化,记录术后并发症发生情况。

    结果:观察组术后疗效Ⅰ级19眼、Ⅱ级11眼、Ⅲ级8眼、Ⅳ级3眼,对照组Ⅰ级16眼、Ⅱ级12眼、Ⅲ级8眼、Ⅳ级3眼,两组比较差异无统计学意义(P>0.05); 观察组视力提升20眼、无变化17眼、视力下降4眼,对照组视力提升16眼、无变化17眼、视力下降6眼,两组比较差异无统计学意义(P>0.05); 观察组角膜愈合时间为3.43±1.03d,对照组为5.13±1.16d,差异具有统计学意义(P<0.05); 两组患者术前和术后1d,1、3、6、12mo眼压比较差异无统计学意义(P>0.05); 术后对照组出现1眼角膜瘢痕,两组患者均未出现眼压升高、角膜散光等并发症。

    结论:采用翼状胬肉转位术联合羊膜移植加绷带型角膜接触镜能显著提高角膜愈合时间,疗效确切,安全有效。

    Abstract:

    AIM: To investigate the effect of pterygium transplantation combined with amniotic membrane transplantation plus bandage type contact lenses.

    METHODS: Totally 72 patients(80 eyes)with pterygium treated in our hospital from December 2014 to December 2016 were enrolled and divided into observation group and control group according to the randomized method, with 37 cases(41 eyes), 35 cases(39 eyes)respectively. The control group was treated with pterygium transplantation combined with amniotic membrane transplantation. On the basis of this, the observation group received bandage contact lens. The postoperative visual acuity, curative effect, recurrence rate, and corneal healing time were recorded during the postoperative 1-year follow-up. Non contact tonometer was used to detect intraocular pressure(IOP)before operation and after operation 1d, 1, 3, 6, and 12mo. Then the incidence of postoperative complications was recorded.

    RESULTS: In order to determine the curative effect, a 4-grade standard was devised, from Ⅰ to Ⅳ. The postoperative efficacy of observation group consisted of 19 eyes in grade Ⅰ, 11 eyes in grade Ⅱ, 8 eyes in grade Ⅲ, 3 eyes in grade Ⅳ, while the control group had 16 eyes in grade Ⅰ, 12 eyes in grade Ⅱ, 8 eyes in grade Ⅲ, 3 eyes in grade Ⅳ, with no significant difference between two groups(P>0.05). Visual acuity in the observation group increased in 20 eyes, remained in 17 eyes, and decreased in 4 eyes. In control group, visual acuity increased in 16 eyes, remained in 17 eyes, and decreased in 6 eyes, with no significant difference between two groups(P>0.05). The corneal healing time was 3.43 ±1.03d in the observation group and 5.13±1.16d in the control group, which was significantly higher in the observation group than in the control group(P<0.05). The IOP of the two groups before operation and after operation 1d, 1, 3, 6, and 12mo showed no significant difference(P>0.05). After the operation, only 1 eyes of corneal scar were found in the control group, and no other complications were found in the two groups such as intraocular pressure and corneal astigmatism.

    CONCLUSION: Compared with pterygium transposition alone, combined amniotic membrane transplantation plus bandage contact lens is an effective and safe way to improve corneal healing time for patients with pterygium.

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张霞,唐强,许倩.翼状胬肉转位术联合羊膜移植加绷带型角膜接触镜治疗翼状胬肉.国际眼科杂志, 2018,18(6):1146-1148.

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  • 收稿日期:2018-02-22
  • 最后修改日期:2018-05-11
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  • 在线发布日期: 2018-05-25
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