羊膜移植术与自体角膜缘干细胞移植术治疗翼状胬肉的效果比较

Effect of limbal stem cell transplantation versus amniotic membrane transplantation in treating pterygium

  • 摘要:
      目的  比较羊膜移植术与自体角膜缘干细胞移植术对翼状胬肉患者术后屈光状态、美容效果的影响及安全性。
      方法  选取84例翼状胬肉患者作为研究对象,采用随机数字表法分为对照组和观察组,每组42例。对照组采用翼状胬肉切除联合自体角膜缘干细胞移植术治疗,观察组采用翼状胬肉切除联合羊膜移植术治疗,比较2组患者手术前后视力、屈光度情况,并比较2组创面愈合时间、术后并发症发生情况和美容效果。
      结果  术后1周、1个月时,2组视力均高于术前,屈光度均低于术前,差异有统计学意义(P < 0.05);2组术后1个月时的视力、屈光度与术后1周时比较,差异无统计学意义(P>0.05);术前、术后1周、术后1个月时,2组间视力、屈光度比较,差异无统计学意义(P>0.05)。观察组创面愈合时间长于对照组,复发率高于对照组,差异有统计学意义(P < 0.05)。2组总并发症发生率比较,差异无统计学意义(P>0.05)。
      结论  羊膜移植术、自体角膜缘干细胞移植术均为翼状胬肉安全有效的手术治疗方法,均可促进患者视力恢复,改善角膜屈光状态,但相较于羊膜移植术,自体角膜缘干细胞移植术可促进创面愈合,降低翼状胬肉术后复发率,获得满意的美容效果。

     

    Abstract:
      Objective  To compare the effect of amniotic membrane transplantation and limbal stem cell transplantation on the refractive status, cosmetic effect and safety for patients with pterygium.
      Methods  A total of 84 patients with pterygium were selected as research subjects. They were divided into control group (42 cases, pterygium surgery combined with limbal stem cell transplantation) and observation group (42 cases, pterygium combined with amniotic membrane transplantation) using random number table method. The visual acuity and refractive power of the two groups before and after the operation were compared, and the wound healing time, postoperative complications and cosmetic effects of the two groups were compared.
      Results  The visual acuity at 1 week and 1 month after operation of the two groups was significantly higher than preoperation, and the refractive power was significantly decreased (P < 0.05). There were no significant changes in visual acuity and refractive power at 1 month after operation when compared with 1 week after operation (P>0.05). There were no significant differences in visual acuity and refractive power between the two groups before operation, 1 week after operation and 1 month after operation (P>0.05). The wound healing time of the observation group was prolonged comparing with the control group (P < 0.05). There was no significant difference in the total complication rate between the two groups (P>0.05). The recurrence rate of the study group was significantly higher comparing with the control group (P < 0.05).
      Conclusion  Membrane transplantation and limbal autologous stem cell transplantation are both safe and effective treatment for pterygium resection. They can both promote vision recovery and improve corneal refractive status. However, limbal autologous stem cell transplantation can promote wound healing and reduce the recurrence rate after pterygium surgery and obtain satisfactory cosmetic results.

     

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