上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (8): 1102-.doi: 10.3969/j.issn.1674-8115.2011.08.012

• 专题报道（眼科视觉科学） • 上一篇    下一篇

丝裂霉素C联合自体游离结膜瓣移植治疗翼状胬肉的临床观察

李 佳1, 周丹虹1, 陆琳娜2   

  1. 1.无锡市第四人民医院眼科, 无锡 214062； 2.上海交通大学 医学院附属第九人民医院眼科, 上海 200011
  • 出版日期:2011-08-28 发布日期:2011-08-29
  • 通讯作者: 陆琳娜, 电子信箱: linatutu@hotmail.com。
  • 作者简介:李 佳（1979—）, 女, 主治医师, 硕士；电子信箱: Lij1979@sina.com。
  • 基金资助:

    上海市重点学科建设项目(S30205)

Clinical observations of conjunctival autografting combined with mitomycin C in treatment of pterygium

LI Jia1, ZHOU Dan-hong1, LU Lin-na2   

  1. 1.Department of Ophthalmology, Wuxi Fourth People's Hospital, Wuxi 214062, China；2.Department of Ophthalmology, the Ninth People's Hospital, Shanghai jiaotong University School of Medicine, Shanghai 200011, China
  • Online:2011-08-28 Published:2011-08-29
  • Supported by:

    Shanghai Leading Academic Discipline Project, S30205

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摘要：

目的 探讨翼状胬肉切除并自体游离结膜瓣移植联合丝裂霉素C(MMC)治疗翼状胬肉后出现并发症的原因、治疗及预防。方法 对139例翼状胬肉患者(153眼)行翼状胬肉切除联合自体结膜瓣移植，术中MMC(0.2 mg/mL)棉片于巩膜面湿敷2 min，随访1年，对术后并发症进行分析。结果 胬肉复发6眼（3.92%）；结膜创口延迟愈合11眼（7.19%）及浅层点状角膜炎9眼（5.88%），未予特殊治疗；结膜瓣溶解7眼（4.58%）、巩膜无血管化2眼（1.31%）及继发青光眼1眼（0.65%），局部药物治疗有效；结膜肉芽肿2眼（1.31%）及角巩膜溶解患者2眼（1.31%），联合手术治疗。结论 联合丝裂霉素C治疗翼状胬肉可降低胬肉复发，但同时可能造成角巩膜溶解等并发症。应术前排除免疫性疾病史，术中注意敷贴放置位置，术后注重随访，以减少并发症发生。

关键词: 翼状胬肉, 丝裂霉素C, 游离结膜瓣移植, 并发症

Abstract:

Objective To observe the clinical outcomes of pterygium excision with mitomycin C combined with conjunctival autografting in treatment of pterygium. Methods A total of 139 patients (153 eyes) with pterygium undergoing pterygium excision were treated with conjunctival autograft combined with mitomycin C (0.2 mg/mL, wet packing on sclera for 2 min). All patients were followed up for 1 year, and postoperative complications were assessed. Results Pterygium recurred in 6 eyes (3.92%). Delayed conjunctival wound healing took place in 11 eyes (7.19%), superficial punctate keratitis occurred in 9 eyes (5.88%), and no special treatment was conducted. Conjunctival flap melting took place in 7 eyes (4.58%), sclera without vascularization occurred in 2 eyes (1.31%), glaucoma happened in 1 eye (0.65%), and topical treatment with drugs were effective. Conjunctival granuloma took place in 2 eyes (1.31%), corneoscleral melting occurred in 2 eyes (1.31%), and topical treatment with drugs and surgery were adopted. Conclusion Conjunctival autografting combined with mitomycin C in pterygium excision may decrease the recurrence of pterygium, but may lead to the complications such as corneoscleral melting. Exclusion of immunological diseases before operation, proper wet packing during operation and regular follow-up after operation can reduce the occurrence of complications.

Key words: pterygium, mitomycin C, conjunctival autografting, complication