Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision
Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision
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DOI：
10.1016/s0161-6420(97)30197-3
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发表时间：
1997-06-01
期刊：
影响因子：
13.7
通讯作者：
Tseng, SCG
中科院分区：
文献类型：
--
作者：
Prabhasawat, P;Barton, K;Tseng, SCG
目的：本研究的目的是确定羊膜是否可以作为翼状胬肉切除术后结膜自体移植物的替代品。设计：一项前瞻性研究，对翼状胬肉患者羊膜移植物（A组）和一期缝合（B组）与结膜自体移植物（C组）进行回顾性比较。A组46眼为原发性翼状胬肉，8眼为复发性翼状胬肉; B组20眼为原发性翼状胬肉; C组78眼为原发性翼状胬肉，44眼为复发性翼状胬肉。对于上述三种不同的手术，组织切除量通过组织病理学分析进行估计，结果通过临床检查进行评估。主要结果测量：复发率，生存分析和最终外观进行比较。A组原发性翼状胬肉复发率为10.9%，复发性翼状胬肉复发率为37.5%，全翼状胬肉复发率为14.8（平均随访时间，12个月），这三个比率显著高于C组的2.6%、9.1%和4.9（平均随访23个月）（分别为P < 0.001、0.018和0.01）。但后者复发率明显低于45% B组原发性翼状胬肉平均随访5.2个月C组复发时间明显延迟于A、B组（P < 0.001）。原发性翼状胬肉相对较低的复发率允许使用羊膜移植作为替代的首选，特别是对于双侧头的晚期病例或以后可能需要青光眼手术的患者。
Objectives: The purpose of the study is to determine whether amniotic membrane can be used as an alternative to conjunctival autograft after pterygium excision.Design: A prospective study of amniotic membrane grafts (group A) and primary closure (group B) was compared retrospectively with conjunctival autografts (group C) in patients with pterygia.Participants: Group A included 46 eyes with primary pterygia and 8 eyes with recurrent pterygia, group B had 20 eyes with primary pterygia, and group C consisted of 78 eyes with primary and 44 eyes with recurrent pterygia.Intervention: For the above three different surgeries, the amount of tissue removed was estimated from histopathologic analysis, and the result was evaluated by clinical examination.Main Outcome Measures: Recurrence, survival analysis, and final appearance were compared.Results: In group A, the recurrence rate was 10.9%, 37.5%, and 14.8% for primary, recurrent, and all pterygia, respectively (mean follow-up, II months), These three rates were significantly higher than 2.6%, 9.1%, and 4.9% noted in group C (mean follow-up, 23 months) (P < 0.001, 0.018, and 0.01, respectively). However, the latter recurrence rate was significantly lower than 45% (mean follow-up, 5.2 months) in group B for primary pterygia (P < 0.001), The onset of recurrence was delayed significantly in group C as compared with that of groups A and B.Conclusions: The relatively low recurrence rate for primary pterygia allows one to use amniotic membrane transplantation as an alternative first choice, especially for advanced cases with bilateral heads or those who might need glaucoma surgery later.