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目的比较下方自体角膜缘干细胞移植术与上方自体角膜缘干细胞移植术治疗翼状胬肉的临床疗效。方法翼状胬肉患者83例100只眼,随机分为两组(下方自体角膜缘干细胞移植组及上方自体角膜缘干细胞组)每组50只眼,失访5例(8只眼)。分别行下方自体角膜缘干细胞移植术和上方自体角膜缘干细胞移植术治疗,术后随访2年。结果两组取材区角膜部位均有角膜缘白色云翳或斑翳,结膜部位无明显瘢痕。角膜创面上皮平均愈合时间下方自体角膜缘干细胞移植组为5.51d(5.51±1.14),上方自体角膜缘干细胞移植术组为6.35d(6.35±1.20),两组比较差异有显著性(F=3.727,P<0.05)。下方自体角膜缘干细胞移植组(45只眼)1只眼复发,复发率为2.22%;上方自体角膜缘干细胞移植术组(47只眼)7只眼复发,复发率为14.89%,两组比较差异有显著性意义(χ2=4.78,P<0.05)。结论自体角膜缘干细胞移植术能使角膜创面修复快,复发率低,是一种理想的手术方法。下方自体角膜缘干细胞移植术术后角膜上皮愈合时间更短,而且遗留的角膜缘部位瘢痕对患者以后进行的眼科手术解剖部位无明显影响而值得推广用。
Objective To compare the clinical efficacy of lower limbal stem cell autograft transplantation with limbal stem cell autografting in the treatment of pterygium. Methods Totally 100 eyes of 83 patients with pterygium were randomly divided into two groups (lower limbal stem cell transplantation group and upper limbal stem cell group) with 50 eyes in each group and 5 eyes lost in 8 eyes. Underwent autologous limbal stem cell transplantation and autologous limbal stem cell transplantation above, respectively, followed up for 2 years. Results The two corneal parts of the two corneal limbus were corneal margins of white clouds or cantharidin, conjunctival site no obvious scar. The mean corneal wound healing time was 5.51 days (5.51 ± 1.14) in the limbal stem cell transplantation group and 6.35 days (6.35 ± 1.20 years) in the limbal stem cell transplantation group. There was significant difference between the two groups (F = 3.727 , P <0.05). In the lower limbal stem cell transplantation group (45 eyes), the recurrence rate was 2.22% in one eye, and in the upper limbal autologous limbal stem cell transplantation group (47 eyes), the recurrence rate was 14.89% in both eyes. The difference was significant (χ2 = 4.78, P <0.05). Conclusion Autologous limbal stem cell transplantation can make the corneal wound repair fast and low recurrence rate, which is an ideal surgical method. The lower corneal epithelium healing time was shorter after autologous limbal stem cell transplantation, and the residual limbal scar had no effect on the subsequent ophthalmic surgical anatomy and was worth promoting.