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目的 :比较角膜干细胞移植与单纯切除治疗翼状胬肉的疗效。方法 :翼状胬肉病人 4 5 2例 (4 5 2眼 )随机分为A、B两组 ,每组各 2 2 6例 (2 2 6眼 )。显微镜下手术 ,A组行切除胬肉加角膜干细胞移植术 ,B组行单纯切除胬肉术。观察术后植片生长、角膜创面修复、角膜新生血管及胬肉复发率。结果 :A组术后 3~ 4d(平均3.4 5d)全部植片成活 ,无感染病例。术后角膜创面修复时间A组为 2~ 4d ,平均 3.4 5d± 0 .97d ;B组为 3~ 7d ,平均 5 .5 1d± 1.2 1d(P <0 .0 1)。角膜新生血管A组有 11例 11眼 ;B组有 71例 71眼。术后 12个月胬肉复发率A组为 4 .3% ,复发 9例 9眼 ,失访 17例 17眼 ;B组为 2 9.9% ,复发 6 2例 6 2眼 ,失访 19例 19眼 (P <0 .0 1)。结论翼状胬肉角膜干细胞移植明显较单纯胬肉切除的疗效好。
Objective: To compare the efficacy of corneal stem cell transplantation and simple resection of pterygium. Methods: Forty-five cases (452 eyes) of pterygium were randomly divided into two groups (A and B), each with 226 cases (226 eyes). Under the microscope, the patients in group A were treated with excision of pterygium and corneal stem cell transplantation, and group B with simple excision of pterygium. Postoperative implant growth, corneal wound repair, corneal neovascularization and recurrence rate of pterygium were observed. Results All the patients in group A survived 3 to 4 days after operation (mean 3.4 days) with no infection. The corneal wound healing time in group A was 2 ~ 4 days (mean 3.4 days ± 0.97 days) and in group B was 3 ~ 7 days (average 5.51 ± 1.2 days) (P <0.01). Corneal neovascularization Group A 11 cases 11 eyes; Group B 71 cases 71 eyes. Twelve months after operation, the recurrence rate of pterygium was 4.3% in group A, 9 of 9 patients were recurrent, 17 of 17 patients were lost to follow-up, 29.9% of patients in group B, 62 of 62 patients were relapsed, 19 of 19 patients were lost to follow-up Eye (P <0. 01). Conclusions Pterygium stem cell transplantation is more effective than simple pterygium excision.