软性角膜接触镜在翼状胬肉切除联合自体角膜缘干细胞移植术后的应用
|
摘要
目的:探讨翼状胬肉切除联合自体角膜缘干细胞移植术后应用软性角膜接触镜的临床效果。。方法:选择单侧翼状胬肉患者90例90眼,按照随机数字表法分为两组:观察组45例45眼翼状胬肉切除联合自体角膜缘干细胞移植术后应用软性角膜接触镜,对照组45例45眼翼状胬肉切除联合自体角膜缘干细胞移植术后不应用软性角膜接触镜。对比两组患者角膜愈合时间,术后1、3、5、7d角膜刺激症状评分,术后24、48h两组患者疼痛程度(VAS评分),翼状胬肉复发率。结果:对照组角膜愈合时间(5. 38±1. 67d)长于观察组(3. 10±1. 12d);术后角膜刺激症状评分、VAS评分高于观察组,差异有统计学意义(P<0. 05);两组患者翼状胬肉复发率比较差异无统计学意义(P>0. 05)。结论:翼状胬肉切除联合自体角膜缘干细胞移植术后应用软性角膜接触镜可减少创面愈合时间,减轻术后角膜刺激症状,同时对胬肉复发率无影响。
AIM: To investigate the clinical effects of soft corneal contact lens after excision of pterygium and lim bal stem cell transplantation in elderly patients.METHODS: Totally 90 patients( 90 eyes) with unilateral pterygium w ere divided into tw o groups according to the random num ber table m ethod. The observation group( 45cases) w ere treated w ith soft corneal contact lens after corneal lim bal autograft transplantation m erely,45 cases of the control group w ere treated by autologous lim bal stem cell transplantation. According to the data obtained from tw o groups of patients, the follow ing indicators w ere com pared: corneal healing tim e,sym ptom score of corneal irritation in 1d, 3d, 5d, 7d after operation,postoperative 24h、48h,tw o groups of patients w ith pain( VAS score),the recurrence rate of pterygium.RESULTS: In control group,the corneal healing time( 5. 38± 1. 67d) was more than that of observation group( 3. 10±1. 12d; P<0.05); Score of the corneal stimulation sym ptom and VAS after operation w ere higher than those of the control group( P < 0. 05),and the difference in recurrence of pterygium w as not statistically significant( P>0.05).CONCLUSION: Autologous corneal stem cells combined with soft corneal contact lens in treatment of elderly patients with pterygium can reduce the healing time,and reduce the postoperative symptom of corneal irritation,meanwhile it has no effect on the recurrence rate of pterygium.
AIM: To investigate the clinical effects of soft corneal contact lens after excision of pterygium and lim bal stem cell transplantation in elderly patients.METHODS: Totally 90 patients( 90 eyes) with unilateral pterygium w ere divided into tw o groups according to the random num ber table m ethod. The observation group( 45cases) w ere treated w ith soft corneal contact lens after corneal lim bal autograft transplantation m erely,45 cases of the control group w ere treated by autologous lim bal stem cell transplantation. According to the data obtained from tw o groups of patients, the follow ing indicators w ere com pared: corneal healing tim e,sym ptom score of corneal irritation in 1d, 3d, 5d, 7d after operation,postoperative 24h、48h,tw o groups of patients w ith pain( VAS score),the recurrence rate of pterygium.RESULTS: In control group,the corneal healing time( 5. 38± 1. 67d) was more than that of observation group( 3. 10±1. 12d; P<0.05); Score of the corneal stimulation sym ptom and VAS after operation w ere higher than those of the control group( P < 0. 05),and the difference in recurrence of pterygium w as not statistically significant( P>0.05).CONCLUSION: Autologous corneal stem cells combined with soft corneal contact lens in treatment of elderly patients with pterygium can reduce the healing time,and reduce the postoperative symptom of corneal irritation,meanwhile it has no effect on the recurrence rate of pterygium.
引文
1 Zhong H,Cha X, Wei T, et al. Prevalence of and risk factors for pterygium in rural adult Chinese populations of the Bai nationality in Dali:the Yunnan Minority Eye Study. Invest Ophthalmol Vis Sci 2012;53(10):6617-6621
2陈嘉宁,姜文浩,吴畅,等.翼状胬肉手术中羊膜移植与自体角膜缘干细胞移植的效果对比.中华眼外伤职业眼病杂志2011;12(1):45-47
3史文净,朱豫.羊膜移植联合丝裂霉素C治疗复发性翼状胬肉疗效研究.中华眼外伤职业眼病杂志2012;34(11):854-855
4寇列玲,杨立平,刘伟,等.自体角膜缘干细胞移植联合双层生物羊膜移植治疗翼状胬肉.国际眼科杂志2014;14(9):1717-1719
5罗康.自体角膜缘干细胞移植术治疗翼状胬肉创面愈合时间和复发率观察.临床合理用药杂志2013;6(23):107-108
6 Artornsombudh P, Sanpavat A, Tinnungwattana U, et al. Prevalence and clinicopathologic findings of conjunctival epithelial neoplasia in pterygia. Ophthalmology 2013;120(7):1337-1340
7李连洲,蔡红军.自体角膜缘干细胞移植治疗翼状胬肉效果观察.中华眼外伤职业眼病杂志2015;37(5):397-398
8 Julio G,Lluch S,Pujol P,et al. Ocular discomfort in pterygium patients. Optom Vis Sci 2013;90(3):269-274
9赵家良,黎晓新,董冬生,等.普拉洛芬滴眼液治疗白内障术后炎症和非感染性眼前段炎症的临床评价.中华实验眼科杂志2000; 18(6):560-564
10赵博,吴江,景红,等.DNA氧化损伤在翼状胬肉发病中的作用.中华实验眼科杂志2013:31(2):160-163
11 Dong Y, Kase S,Dong Z, et al. Regulation of vascular endothelial growth factor-Cby tumor necrosis factor-αin the conjunctiva and pterygium. Int J Mol Med 2016; 38(2):545-550
12 Kositphipat K,Tananuvat N, Choovuthayakorn J. Results of pterygium excision adjunct with conjunctival autograft transplantation for primary pterygium by ophthalmology trainees. Int Ophthalmol 2016; 36(5):615-621
13 Li YY.Primary Pterygium combined theapeutic effect observation. Clin Exp Med 2015; 14(17):1464-1465
14 Cope JR,Collier SA,Srinivasan K,et al. Contact lens-related corneal infections-United States, 2005-2015. Morb Mortal Wkly Rep 2016; 65(32):817-820
15 Gallagher AG, Alorabi JA, Wellings DA, et al. A novel peptide hydrogel for an antimicrobial bandage contact lens. Adv Health Mater2016;5(16):2013-2018
16 Shigeyasu C,Yamada M,Akune Y,et al. Diquafosol for soft contact lens dryness:clinical evaluation and tear analysis. Optom Vis Sci 2016;93(8):973-978
2陈嘉宁,姜文浩,吴畅,等.翼状胬肉手术中羊膜移植与自体角膜缘干细胞移植的效果对比.中华眼外伤职业眼病杂志2011;12(1):45-47
3史文净,朱豫.羊膜移植联合丝裂霉素C治疗复发性翼状胬肉疗效研究.中华眼外伤职业眼病杂志2012;34(11):854-855
4寇列玲,杨立平,刘伟,等.自体角膜缘干细胞移植联合双层生物羊膜移植治疗翼状胬肉.国际眼科杂志2014;14(9):1717-1719
5罗康.自体角膜缘干细胞移植术治疗翼状胬肉创面愈合时间和复发率观察.临床合理用药杂志2013;6(23):107-108
6 Artornsombudh P, Sanpavat A, Tinnungwattana U, et al. Prevalence and clinicopathologic findings of conjunctival epithelial neoplasia in pterygia. Ophthalmology 2013;120(7):1337-1340
7李连洲,蔡红军.自体角膜缘干细胞移植治疗翼状胬肉效果观察.中华眼外伤职业眼病杂志2015;37(5):397-398
8 Julio G,Lluch S,Pujol P,et al. Ocular discomfort in pterygium patients. Optom Vis Sci 2013;90(3):269-274
9赵家良,黎晓新,董冬生,等.普拉洛芬滴眼液治疗白内障术后炎症和非感染性眼前段炎症的临床评价.中华实验眼科杂志2000; 18(6):560-564
10赵博,吴江,景红,等.DNA氧化损伤在翼状胬肉发病中的作用.中华实验眼科杂志2013:31(2):160-163
11 Dong Y, Kase S,Dong Z, et al. Regulation of vascular endothelial growth factor-Cby tumor necrosis factor-αin the conjunctiva and pterygium. Int J Mol Med 2016; 38(2):545-550
12 Kositphipat K,Tananuvat N, Choovuthayakorn J. Results of pterygium excision adjunct with conjunctival autograft transplantation for primary pterygium by ophthalmology trainees. Int Ophthalmol 2016; 36(5):615-621
13 Li YY.Primary Pterygium combined theapeutic effect observation. Clin Exp Med 2015; 14(17):1464-1465
14 Cope JR,Collier SA,Srinivasan K,et al. Contact lens-related corneal infections-United States, 2005-2015. Morb Mortal Wkly Rep 2016; 65(32):817-820
15 Gallagher AG, Alorabi JA, Wellings DA, et al. A novel peptide hydrogel for an antimicrobial bandage contact lens. Adv Health Mater2016;5(16):2013-2018
16 Shigeyasu C,Yamada M,Akune Y,et al. Diquafosol for soft contact lens dryness:clinical evaluation and tear analysis. Optom Vis Sci 2016;93(8):973-978