Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision
Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision
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DOI：
10.1001/archopht.1997.01100160405001
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发表时间：
1997-10-01
影响因子：
--
通讯作者：
Lim, ASM
中科院分区：
文献类型：
--
作者：
Tan, DTH;Chee, SP;Lim, ASM
目的：比较结膜自体移植术和裸巩膜切除术治疗热带地区原发性和复发性翼状胬肉的成功率，并评估翼状胬肉复发的危险因素。方法：进行了一项前瞻性对照临床试验，其中123例原发性和34例复发性翼状胬肉，年龄和翼状胬肉形态相匹配，随机分为2个独立的研究，接受裸巩膜切除术或结膜自体移植术。由一名外科医生进行手术，并在术后1、3、6和12个月由一名独立观察员进行审查。根据对翼状胬肉透明性的评估，翼状胬肉的形态在临床上被分为萎缩性、中间性或肉质。使用似然比检验评估风险因素。使用威布尔曲线估计复发率，允许区间删失。原发性翼状胬肉组（平均随访，15.1个月），62例巩膜裸露切除术中38例（61%）61例自体结膜移植术中，1例（2%）翼状胬肉复发（以下简称结膜签名组）（P
Objectives: To compare success rates of conjunctival autografting and bare sclera excision for primary and recurrent pterygium in the tropics and to evaluate risk factors for pterygium recurrence.Methods: A prospective, controlled clinical trial was performed in which 123 primary and 34 recurrent pterygia, matched for age and pterygium morphology, were randomized in 2 separate studies to receive either bare sclera excision or conjunctival autograft. The surgical procedures were performed by one surgeon and reviewed at 1, 3, 6, and 12 months after surgery by an independent observer. Pterygium morphology was clinically graded as atrophic, intermediate, or fleshy according to an assessment of pterygium translucency. Risk factors were assessed using likelihood ratio tests. Weibull curves were used to estimate recurrence rates allowing for the interval censoring.Results: In the group with primary pterygium (mean follow-up, 15.1 months), 38 (61%) of the 62 cases of bare sclera excision (heretofore referred to as the bare sclera group) had pterygium recur in contrast with 1 (2%) of the 61 cases of conjunctival autograft (heretofore referred to as the conjunctival autograph group) (P