准分子激光治疗性角膜切削术在治疗复发性翼状胬肉中疗效观察.docVIP

准分子激光治疗性角膜切削术在治疗复发性翼状胬肉中疗效观察 　　[摘要] 目的 探讨准分子激光治疗性角膜切削术（PTK）在治疗复发性翼状胬肉中的手术要点和临床效果。 方法 回顾性分析我院2010 年6 月～2013 年12 月收治的51例（52眼）复发性翼状胬肉患者的临床资料，根据不同治疗方法随机分为两组，A组采用胬肉切除联合角膜缘干细胞移植术+PTK术，B组单纯采用胬肉切除联合角膜缘干细胞移植术，术后随访6个月。观察两组疗效并对术后角膜创面上皮愈合时间、角膜平整透明度、角膜散光、角膜新生血管生长情况及复发率等进行比较。 结果 角膜创面上皮平均愈合时间，A组为3～7（5.00±1.26）d，B组为 4～8（6.25±1.36）d，差异有统计学意义（t=-2.65，P=0.0130.05），但A组角膜新生血管增殖情况优于B组（Z=-3.053，P=0.0020.05）。 结论 PTK治疗复发性翼状胬肉恢复较快，术后角膜平滑及透明度优于单纯采用胬肉切除联合角膜缘干细胞移植术，可供临床选用。 　　[关键词] 复发性翼状胬肉；准分子激光；激光治疗性角膜切削术；角膜缘干细胞移植 　　[中图分类号] R779.63 [文献标识码] B [文章编号] 1673-9701（2015）14-0061-03 　　[Abstract] Objective To investigate the key points of operation and clinical effects of excimer laser phototherapeutic keratectomy（PTK） in the treatment of recurrent pterygium. Methods Perform a retrospective study method. 51 patients（52 eyes）who were diagnosed recurrent pterygium from June 2010 to December 2013 were allocated into two groups at random： group A was treated by pterygium excision and corneal limbal stem cell autograft （CAG） with PTK and group B was simply treated by CAG. They were followed up in the aspects of the reparation of cornea，astigmatism and the recovery of visual acuity for six months. The recurrence rate was also analyzed and compared. Results The average healing time of group A was 3-7 （5.00±1.26） d， while group B was 4-8 （6.25±1.36） d， the difference of which was statistically significant （t=-2.65， P=0.0130.05）， but the proliferation of corneal neovascularization in group A was reduced than that of group B（Z= -3.053，P=0.0020.05）. Conclusion The results suggest that PTK can be an effective therapeutic approach in the treatment of recurrent pterygium. 　　[Key words] Recurrent pterygium； Excimer laser； Phototherapeutic keratectomy；Corneal limbal stem cell autograft 　　翼状胬肉是眼科常见的慢性眼表疾病，多发于中老年人群，目前尚无确切的药物治疗手段，临床主要治疗方法是手术切除，但复发率较高，复发性翼状胬肉更是临床治疗的一个难点。我院应用翼状胬肉切除联合角膜缘干细胞移植（corneal limbal stem cell autograft，CAG）+准分子激光治疗性角膜切削术（excimer laser phototherapeutic keratectomy，PTK）治疗复发性翼状胬肉，获得较好疗效，现报道如下。