Efficacy Of Improved Method Of Pterygium Surgery

Object:Through the improvement of pterygium excision in the surgical procedure, comparative analysis of different methods of surgical treat- ment. In this study, the fascia with clear dysplasia, fibrous hyperpl- asia and with improved methods of scleral suture-intensive instead of the traditional simple way. Compare Pterygium excision with conjunctival autograft transplantation technique used in these two kinds of clinical results, and explore how to improve the surgical procedure to enhance the therapeutic effect of pterygium and reduce the recurrence rate after pterygium excision.Methods:A retrospective analysis of 148 patients, 156 eyes (female 68 cases, 72 eyes; male 80 cases, 84 eyes) from January 2005 to December 2009, which were due to pterygium surgery in our hospital. All cases were excluded other eye diseases and related systemic diseases,and according to different surgical methods were divided into two groups: A group of traditional pterygium excision combined with autologous conjunctival transplantation 83 eyes (73 primary, 10 recurrent); B group improved conjunctival pterygium excision combined with autologous transpla- ntation 73 eyes (65 primary, 8 recurrent). All patients were followed up for 6 months to 2 years. Cases were observed the conjunctival and corneal repair, postoperative complications and recurrence of pterygium, evaluate its efficacy and Statistical analysis of the effect of two different surgical methods.Results:We studied 148 cases ,156 eyes for resection of the pterygium .To patients without recurrence ,conjunctival graft become transparent for 7 ~ 10ds; corneal epithelial involvement of District were and conjunctival incision were healed well for 3 ~ 10ds.17 cases of patients with recurrence, the recurrence rate was 10.90%. It was generally believed that the postoperative recurrence of pterygium should be followed up for 4 to 6 months, our follow-up time is more than the length from 6 to 24 months.The recurrence rate between the two groups: 13 recurrences (15.66%) were observed in the group of traditional pterygium excision combined with autologous conjunctival transplantation; 4 recurrences (5.48%) in the group improved conjunctival pterygium excision combined with autologous transplantation. A group and B group:χ2 = 4.14, P <0.05. There was a significant difference, statistically significant.The two groups of recurrent pterygium recurrence rates were compared: A group of six recurrences, recurrence rate was 60.0%; B group a recurrence, recurrence rate was 12.5%.The total number of patients was due to less than 40, suggested Fisher exact test, P = 0.0157 <0.05, significant difference. The modified pterygium excision combined with autologous conjunctival transplantation for recurrent pterygium should be effective to reduce the recurrence rate of secondary surgery .It was observed that mild edema, local congestion, with foreign body sensation, photophobia and irritation symptoms such as tears,in all cases at early postoperative graft . Comparing of the patients referred to the duration and intensity of postoperative stimulus symptoms,the A group is more obvious than the B group.4 cases were observed conjunctival flap formation fold by the movement regional organizations in A group; 1 cases were observed conjunctival flap contraction and cyst in A group; no significant complications can be found to influence of visual acuity in postoperative patients.Conclusion:Improvement group recurrence rate is low, the healing effects is good with few complications.Although the removal of the fascia dysplasia, fibrous hyperplasia and dense with scleral suture technique is relatively difficult and more time consumed, but it was found to be superior from the cosmetic angle and surgical results.