Amniotic membrane transplantation after extensive removal of primary and recurrent pterygia
Amniotic membrane transplantation after extensive removal of primary and recurrent pterygia
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DOI：
10.1016/s0161-6420(00)00567-4
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发表时间：
2001-03-01
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：
Solomon, A;Pires, RTF;Tseng, SCG
目的评价原发翼状胬肉广泛切除与复发翼状胬肉联合羊膜移植的术后疗效及复发率。设计非比较性介入病例系列。参与者：54例原发（n = 33）或复发（n = 21）翼状胬肉患者的54只眼睛，由一名外科医生（SCGT）进行手术。干预措施：所有患者手术治疗翼状胬肉，广泛切除病变，然后进行羊膜移植和术中注射储备皮质类固醇。结膜（3级）和角膜（4级）复发率和并发症发生率的累积率。结果：原发翼状胬肉平均随访12.8 +/- 4.3个月，复发翼状胬肉平均随访14.3 +/- 4.9个月。原发、复发和所有翼状胬肉的真实复发率（4级）分别为3.0%、9.5%和5.6%。12个月无复发眼的累积比例原发性为0.90 +/- 0.06，复发性翼状胬肉为0.69 +/- 0.11 （P = 0.047， log-rank检验）。切除半月皱襞可延长生存时间（P = 0.063），降低手术失败率（P = 0.046），双头翼状胬肉手术成功率相似（11眼1例复发）。结论：羊膜移植治疗翼状胬肉是一种安全有效的手术方法，对于原发性和复发性翼状胬肉的复发率都相对较低，当需要覆盖大面积结膜缺损时，如原发性双头翼状胬肉和大面积复发性翼状胬肉，羊膜移植是自体结膜移植的一种有效选择。(C) 2001年由美国眼科学会发布。
Objectives To evaluate the postoperative outcome and the recurrence rate after extensive removal of primary and recurrent pterygia combined with amniotic membrane transplantation.Designs A noncomparative interventional case series.Participants: Fifty-four eyes in 54 subjects with either primary (n = 33) or recurrent (n = 21) pterygia operated on by one surgeon (SCGT).Intervention: All subjects were operated on for pterygia with an extensive excision of the lesion followed by amniotic membrane transplantation and intraoperative injection of a depot corticosteroid.Main Outcome Measures Cumulative rates of conjunctival (grade 3) and corneal (grade 4) recurrence and incidence of complications.Results: The mean follow-up was 12.8 +/- 4.3 months for primary and 14.3 +/- 4.9 months for recurrent pterygia. The true recurrence rate (grade 4) was 3.0%, 9.5%, and 5.6% for primary, recurrent, and all pterygia, respectively. The cumulative proportion of recurrence-free eyes at 12 months was 0.90 +/- 0.06 for primary and 0.69 +/- 0.11 for recurrent pterygia (P = 0.047, log-rank test). Removal of the semilunar fold was associated with longer survival times (P = 0.063) and decreased failure rate (P = 0.046), A similar success rate was achieved in double-head pterygia (1 recurrence in 11 eyes).Conclusions: Amniotic membrane transplantation is an effective and safe procedure for pterygium surgery, with a relatively low recurrence rate for both primary and recurrent pterygia, It can be a useful alternative to conjunctival autograft when a large conjunctival defect has to be covered, such as in primary double-head pterygia and in large recurrent pterygia. (C) 2001 by the American Academy of Ophthalmology.