| Objective:Pterygium is one of the common chronic ocular surface diseases which is the triangular membrane proliferation of local conjunctiva and fibr》 ovascular tissue. The specific reason maybe related with the ultraviolet radiation, dry climate and dust exposure which is still unknown definitely.With the development of pterygium,the corneal refractive status change,with the obstruction of vision that is aside from cosmesis.Surgeon is the major measure to treat the disease,but the recurrence of traditional technique is much high.There has been no consensus on the best procedure.However,In recent years,with the improvement of operation method,it provoid many brand-new therapy ways for the disease.Therefore,we explore a new kind of surgery for the illness--Reverse conjunctival autograft transplantation.We expect to evaluate the therapeutic effect of this new method by comparing with other ones like Simple pterygium excision and limbal epithelium autograft transplantation.Methods:A prospective randomized paired-eye trial was studied.There are 61 patients (76 eyes)with pterygium(6 eyes with recurrent pterygium)which is observed in Qilu hospital in Shandong province from August 2014 to September 2015,and they were allocated to three groups:simple pterygium excision (A group 23 eyes), limbal epithelium autograft transplantation(B group 28 eyes)and Reverse conjunctival autograft transplantation(C group 25 eyes).The criteria for recovery were corneal transparent with stable epithelial healing and no abnormal proliferation of pterygium-like tissue;Or it seems to be recurrent.The post-operative follow-up periods is 1 year,and review after 1、2、3、4、6month respectively with the examination of recover condition,vision and astigmatism.Results:Some of the patients lost follow-up.The data are compared statistically by using the t test and U test two-sample rate, etc. There here are 61 patients (76 eyes)with pterygium to be observed.The average age is (60±10.7) years,the average course is (9.5±7.6) years.The distance to limbus is (3.42+1.45)mm.In the follow-up,6 of 23 eyes(26.1%)were recurred in A group,which is significantly different from B group with 2 of 28 eyes(7.1%)and C group with 1 of 25 eyes(4%)(P<0.05),and the recurrent of B and C group has no significantly difference(P>0.05).The difference of vision and astigmatism between pre-operation and post-operation is significant.(P<0.05)。In Cgroup,the area of conjunctival flap is (21.2+8.34) mm2 on average,the period of congestion is (10.56±6.14) d and removing the stitches is (14.24±4.91)d, the repair time of trauma is (4.73+1.15)d,and the healing process of conjunctival flap is (35.08±13.37) d There are 2 cases with traction of conjunctival flap and 4 cases of hypertension.Severe complications after the operation such as granulation hyperplasia, constrictive fornix, oculomotor defect, and others were not observed.Conclusion:Reverse conjunctival autograft transplantation is a new effective treatment for pterygium so as to improve vision with no severe complication.However,it requires a proper dispose with the conjunctival flap so as to ensure the low recurrence and avoid more complications. |
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