Evaluation of the Safety and Efficacy of a Low-Temperature Plasma Surgical System for Pterygium.
Evaluation of the Safety and Efficacy of a Low-Temperature Plasma Surgical System for Pterygium.
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DOI：
10.1097/ico.0000000000002487
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发表时间：
2020-12
期刊：
影响因子：
2.8
通讯作者：
Yuan J
中科院分区：
文献类型：
--
作者：
Huang H;Li S;Zhong J;Wang B;Peng L;Deng Y;Wang M;Yuan J
手术切除是翼状胬肉的标准治疗方法。本研究旨在评估低温血浆（LTP）用于翼状胬肉手术切除和止血的新技术的安全性和有效性。对60例（60只眼）行翼状胬肉切除自体结膜纤维蛋白胶移植术的患者进行了前瞻性、对比性和随机临床试验。患者平均分为两组：对照组和LTP组。术后第1天、第1周、第1个月和第3个月随访，1年后评估复发情况。检查患者的手术时间、最佳矫正视力、自体结膜炎症（CAI）、移植物稳定性（GS）、疼痛、复发和最终外观。分析与翼状胬肉复发及最终外观相关的因素。LTP组平均手术时间（16.7±3.4 min）短于对照组（20.1±4.7 min, P = 0.002）。术后第1天（P = 0.000）和第1周（P = 0.000） LTP眼的CAI较对照眼轻。与对照组相比，LTP组患者第1天的GS改善（P = 0.01），疼痛减轻（P = 0.04）。对照组2例（6.7%），LTP患者无复发（0%）（P = 0.08）。GS和CAI是导致复发的显著因素（GS: R = 0.425, P = 0.001; CAI: R = 0.309, P = 0.016）。LTP替代手术刀片和一次性烧灼进行消融止血，对于翼状胬肉手术安全有效，手术时间短，炎症较轻，移植物稳定性较好，且不增加并发症风险。
Surgical excision is the standard treatment for pterygium. This study was conducted to evaluate the safety and efficacy of a novel technique using low-temperature plasma (LTP) for excision and hemostasis in pterygium surgery. A prospective, comparative, and randomized clinical trial was conducted on 60 patients (60 eyes) undergoing pterygium excision with conjunctival autografts using fibrin glue. Patients were equally divided into the following 2 groups: a control group and a LTP group. Postoperative follow-up visits were scheduled on day 1, week 1, and months 1 and 3, and recurrence was evaluated at 1 year. Patients were examined for operative time, best corrected visual acuity, conjunctival autograft inflammation (CAI), graft stability (GS), pain, recurrence, and final appearance. Factors related to pterygium recurrence and final appearance were analyzed. Mean operative times were shorter in the LTP group (16.7 ± 3.4 min) than those in the control group (20.1 ± 4.7 min, P = 0.002). LTP eyes had milder CAI than control eyes at postoperative day 1 (P = 0.000) and week 1 (P = 0.000). Patients in the LTP group exhibited better GS (P = 0.01) and milder pain (P = 0.04) than those in the control group on day 1. Two control patients (6.7%) and no (0%) LTP patients experienced recurrence (P = 0.08). GS and CAI were the significant factors contributing to recurrence (GS: R = 0.425, P = 0.001; CAI: R = 0.309, P = 0.016). LTP to replace surgical blades and disposable cautery for ablation and hemostasis is safe and efficient for pterygium surgery, resulting in shorter operative time, milder inflammation, and better graft stability without increasing complication risk.