复发性翼状胬肉切除加自体结膜缘缘移植-我们的结果

S. Kodavoor, P. Venkatesh, R. Dandapani, G. Sachdev
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摘要

目的:分析复发性翼状胬肉扩大切除及自体结膜移植术后的复发率及并发症。材料与方法:对214例患者216只眼进行回顾性分析。所有手术均在结膜下浸润麻醉下进行。广泛切除翼状胬肉,同时切除周围1mm的正常结膜组织,并切除结膜边缘后面和以外的所有腱。从上结膜取一个大的自体结膜移植物,移植物中有薄块的角膜缘组织,以适当的方向(角膜缘端朝向角膜)放置在裸巩膜上,并用纤维蛋白胶固定。6例自体角膜缘组织移植自下结膜,因上结膜因先前手术而结疤,术中未使用其他佐剂。结果:214例患者中单侧复发性翼状胬肉212例,双侧复发性翼状胬肉2例。所有患者至少随访6个月,平均随访18个月。复发6眼(2.7%),其中早期1次复发2眼,早期2次复发3眼,既往3次复发1眼。结论:翼状胬肉扩大切除联合自体大结膜植入术是治疗复发性翼状胬肉的有效手术方法,复发率低,效果好。
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Recurrent Pterygium Excision with Extended Resection and Limbal Conjunctival Autograft - Our Results
Aim: To analyze the recurrence rates and complications after extended resection and limbal conjunctival autograft in recurrent pterygium cases. Materials and methods: Retrospective analysis of 216 eyes of 214 patients was done. All the surgeries were performed under subconjuctival infiltrative anaesthesia. Extensive excision of the pterygium was done along with 1mm of normal conjunctival tissue all around and the tenons was resected all around behind and beyond the excised conjunctival margins. A large conjunctival autograft with a thin block limbal tissue in the graft was taken from the superior conjunctiva and placed on the bare sclera with proper orientation (limbal end towards the cornea) and was fixed with fibrin glue. In 6 cases the autograft with the limbal tissue was taken from the inferior conjunctiva as the superior conjunctiva was scarred due to previous surgeries No other adjuvants were used during the procedure. Results: Among the 214 patients, 212 patients had unilateral recurrent pterygium and 2 patients had bilateral recurrent pterygium. All the patients were followed up for a minimum of 6 months with an average follow up of 18 months. Recurrence was seen in 6 eyes (2.7%), out of which 2 eyes had one recurrence earlier, 3 eyes had two recurrences earlier and one eye had three recurrences before. Conclusion: Extended pterygium resection with large limbal conjunctival autograft seems to be an effective surgical procedure in recurrent pterygium with less recurrence and encouraging results.
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