摘要： 目的 评估上下方角膜缘干细胞移植术对翼状胬肉切除术后泪膜的不同影响。方法 将2015年1月至2018年1月我院翼状胬肉住院患者200例（231眼）随机分为A组（92例，行翼状胬肉切除联合上方角膜缘移植术）和B组（108例，行翼状胬肉切除联合下方角膜缘移植术）。分别于术前1 d、术后1个月、3个月行干眼主观症状问卷评分（SDES）和角膜荧光素染色评分（SCSF），利用Oculus Keratograph眼表综合分析仪测定非侵入性泪膜破裂时间（NIBUT）和泪河高度（TMH）。采用随机区组设计的方差分析对数据进行统计学分析。结果 术后1个月时，与A组相比，B组SDES增高，BUT缩短，TMH变低，SCSF增高，差异均有统计学意义（均P < 0.05），术后3个月时，2组以上指标均无统计学差异。结论 翼状胬肉切除术后早期，下方角膜缘移植术对眼表的影响明显大于上方角膜缘移植术，3个月后2种手术方式对眼表的影响无明显差异。

翼状胬肉切除联合不同部位角膜缘干细胞移植术对泪膜的影响

杨静, 杨军, 陈海波

中山大学中山眼科中心海南眼科医院, 海南省眼科医院一病区, 海南省眼科学重点实验室, 海口 570311

收稿日期:2021-04-06出版日期:2022-02-28发布日期:2022-01-05
通讯作者:杨静E-mail:yj19840116yj@163.com
作者简介:杨静(1985-),女,副主任医师,硕士.
基金资助:海南省自然科学基金（2017CXTD011，817364）


关键词: 泪膜, 翼状胬肉切除术, 角膜缘干细胞移植术
Abstract: Objective To investigate the influence of superior or inferior limbal stem cell transplantation onto ocular surface after pterygium excision. Methods Two hundred and thirty one eyes from 200 patients were studied. Patients were divided into two groups. In group A (92 cases), pterygium excision was performed with superior limbal stem cell transplantation. In group B (108 cases), pterygium excision was performed with inferior limbal stem cell transplantation. Score of dry eye symptoms (SDES) was recorded at 1 d prior to surgery, and 1 month and 3 months postoperatively. Non-invasive tear break-up time (NIBUT), tear meniscus height (TMH), and score of cornea fluorescein staining (SCSF) were examined with an Oculus Keratograph at 1 d prior to surgery, and at 1 and 3 months postoperatively. Data were analyzed by randomized analysis of variance using SPSS 22.0. Results At 1 month post-surgery, SDES was increased, BUT shortened, TMH decreased, and SCSF increased in group B relative to group A. These differences were statistically significant (all P < 0.05). At 3 months post-operation, the above indices displayed no statistical differences between groups (P > 0.05). Conclusion In the early recovery stage after pterygium excision, the effect of inferior stem cell transplantation on the ocular surface is significantly greater than that of superior stem cell transplantation. However, no significant difference is observed during the later postoperative period.
Key words: tear film, pterygium excision, limbal stem cell transplantation
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