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@#AIM:To investigate the curative effect of pterygium excision combined with free conjunctival flap transplantation on primary pterygium and the influence on tear film function.<p>METHODS:Totally 120 patients(126 eyes)with primary pterygium who were admitted to the hospital between January 2018 and October 2019 were selected as the research subjects. They were divided into two groups according to the random number table method. 62 cases(64 eyes)in the conjunctival transplantation group were treated with pterygium excision combined with free conjunctival flap transplantation. 58 cases(62 eyes)in the amniotic membrane transplantation group were treated with pterygium excision combined with amniotic membrane transplantation. The length of Schirmer's-Ⅰ test(SⅠt), tear film break-up time(BUT), corneal fluorescein staining(FL)scores, noninvasive Keratograph tear breakup time(NIBUT), determine tear river height(TMH)and conjunctival goblet cell count were determined before surgerry, at 3mo and 6mo after surgery. Patients' quality of life was evaluated with ocular surface disease index(OSDI), and the therapeutic effect and recurrence were evaluated at 6mo after surgery.<p>RESULTS: There was no significant difference in the average repair time of corneal epithelium or the duration of symptoms between the conjunctival transplantation group and the amniotic membrane transplantation group(<i>P</i>>0.05). At 6mo after surgery, the BUT \〖(11.11±2.77)s <i>vs</i>(10.01±2.41)s\〗, NIBUT \〖(10.01±1.52)s <i>vs </i>(9.52±0.98)s\〗 in conjunctival transplantation group was longer than that in the amniotic membrane transplantation group(<i>P</i><0.05), and the FL score was lower than the amniotic membrane transplantation group \〖(0.44±0.10)points <i>vs</i>(0.50±0.11)points\〗(<i>P</i><0.05). The conjunctival goblet cell counts in both groups were increased significantly after surgery(<i>P</i><0.05). At 3mo and 6mo after surgery, the counts in conjunctival transplantation group were larger than those in the amniotic membrane transplantation group \〖(311.41±58.45)/mm<sup>2</sup> <i>vs</i>(285.46±68.96)/mm<sup>2</sup>,(342.41±66.89)/mm<sup>2</sup> <i>vs</i>(314.41±70.12)/mm<sup>2</sup>\〗(<i>P</i><0.05). The OSDI scores of both groups were significantly decreased after surgery(<i>P</i><0.05), but there was no significant difference between groups(<i>P</i>>0.05). There was no statistically significant difference in the overall curative effect between the two groups(<i>P</i>>0.05). The recurrence rates in the conjunctival transplantation group and the amniotic membrane transplantation group were 6.3% and 6.5%, respectively(<i>P</i>>0.05).<p>CONCLUSION: Pterygium resection combined with autologous conjunctival flap transplantation is equivalent to amniotic membrane transplantation in terms of postoperative recovery and prevention of pterygium recurrence. Both can improve the stability of patients' tear film function.
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@#AIM: To investigate the clinical analysis of dry eye and tear film stability in pterygium patients after autologous conjunctival flap transplantation. <p>METHODS: Totally 114 cases of 138 eyes with pterygium were selected and divided into 56 groups of 67 eyes in the traditional group and 58 eyes of 71 eyes in the experimental group. The SⅠt values and BUT values of the two groups were observed before, 1 and 3mo after the operation, FL value, eye surface temperature and dry eye score of the two groups after surgery.<p>RESULTS: The total effective rate of the traditional group was 83.6%, and the total effective rate of the experimental group was 95.8%. The difference between the two groups was statistically significant(χ2=5.207, <i>P</i>=0.022); there was no difference in the SⅠt value before surgery between the two groups(<i>P</i>>0.05 ), SⅠt values in the experimental group increased significantly at 1, 3mo after surgery compared with the traditional group(both <i>P</i><0.05); there was no difference in BUT values before surgery in the traditional and experimental groups(<i>P</i>>0.05), and at 1 and 3mo after surgery the BUT value in the group was significantly increased compared with the traditional group(both <i>P</i><0.05); there was no difference in the FL score between the traditional group and the experimental group before surgery(<i>P</i>>0.05).FL value was decreased in the experimental group campared to the traditional group 1, 3mo after surgery(All <i>P</i><0.05); there was no difference in eye surface temperature between the traditional group and the experimental group(<i>P</i>>0.05), and the dry eye score test group was significantly lower than the traditional group(<i>P</i><0.05).<p>CONCLUSION: Autologous conjunctival flap transplantation is superior to simple tendon resection, which can promote the recovery of tear film stability in patients with pterygium, and the dry eye symptoms of patients are significantly improved.
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AIM: To observe the efficacy of surgical excision combined with autologous limbus conjunctival flap transplantation in the treatment of pterygium accompanied with conjunctival cyst.METHODS: Totally 126 patients 188 eyes with pterygium were hospitalized in Department of Ophthalmology of Tongji Hospital of Huazhong University of Science and Technology during August 2013 and August 2015.The patients were divided into two groups: observation group (11 eyes of 11 patients) with pterygium accompanied with conjunctival cyst and control group (177 eyes of 115 patients) with primary pterygium.All patients underwent slit lamp microscope examination, anterior segment photography, and anterior segment optical coherence tomography(OCT).The size of pterygium was calculated by multiplying neck width and length of the covered corneal.All patients underwent excision combined with autologous conjunctival flap transplantation, and the resections were performed pathological section with hematoxylin and eosin staining.All patients were followed up postoperatively for 4-28mo.RESULTS: All cases in the observation group were confirmed by postoperative pathological examination.All cyst walls were complete, and containing single layer of epithelial cells.The mean size of pterygium of the observation group was 6.9±1.7mm2, and 6.3±1.8mm2 for the control group.There was no significant difference between the two groups (P>0.05).The mean postoperative healing time of observation group was 2.1±0.9d, and 1.9±0.8d for the control group.There was no significant difference between the two groups (P>0.05).Recurrence was seen in two eyes within the follow-up period in the control group, and no recurrence in the observation group.CONCLUSION: Surgical excision combined with autologous limbus conjunctival flap transplantation is a safe and effective treatment for pterygium accompanied with conjunctival cyst.
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AIM:To compare the effect of three types of pterygium surgery and on tear film in patients with type 2 diabetes mellitus. ·METHODS:A total of 102 patients ( 102 eyes ) with pterygium combined with type 2 diabetes mellitus treated in our hospital from March 2013 to March 2016 were analyzed retrospectively. The patients were divided into three groups including the 34 cases ( 34 eyes ) with simple excision of pterygium ( resection group ) , pterygium excision combined with conjunctival flap transplantation in 34 cases (34 eyes, as conjunctival flap group ) and pterygium excision combined with limbal stem cell transplantation in 34 cases ( 34 eyes, as stem cell group ) . The wound repair time, complications, recurrence rate, uncorrected visual acuity (UCVA), tear film break-up time ( BUT ) and basal tear secretion test (SⅠt) were observed before, and 6 and 12mo after surgery in the three groups, respectively. ·RESULTS:The postoperative UCVA of the three groups was significantly higher than that preoperation ( P =0. 039, 0. 013, 0. 024 ), and there was no significant difference among the three groups ( P = 0. 317 ). The wound repair time was 5. 67 ± 1. 45d in the resection group, which was significantly higher than that in the conjunctival flap group (4. 18 ± 0. 76d) and the stem cell group (4. 09±0. 79 d) (P<0. 001), there was no significant difference between the conjunctival flap group and the stem cell group ( P = 0. 937 ). There were 4 cases in resection group reappeared, and the recurrence rate was 11. 8%, which was significantly higher than the other two groups ( P = 0. 037 ). There were 1 recurrences in the conjunctival flap group, and the recurrence rate was 2. 9%, while the patients in the stem cell group had no obvious recurrence. SⅠt and BUT increased significantly after operation (P<0. 05), especially in conjunctival flap group and stem cell group (P<0. 001). There was no significant difference between the conjunctival flap group and the stem cell group (P=0. 845, 0. 894). · CONCLUSION: Pterygium excision combined with conjunctival flap transplantation or limbal stem cell transplantation for the treatment of type 2 diabetic patients with normal blood glucose and tear film function has the similar effect, and is better than simple pterygium excision.
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AIM: To investigate effect of autogenous conjunctival flap transplantation in the treatment of severe fungal corneal ulcer. METHODS: A total of 83 cases ( 83 eyes ) with severe fungal corneal ulcer treated in our hospital from Jan. 2013 to Jan. 2016 were selected. Among them, 36 cases ( 36 eyes) were treated with drug therapy, and 47 patients(47 eyes ) were treated with autogenous conjunctival flap transplantation, two group did fungal culture and identification, observed the two groups treatment effect.RESULTS:The effective rate of surgical treatment group was 89%, significantly higher than that of drug treatment group, the difference was statistically significant ( P CONCLUSION: Autologous conjunctival flap transplantation in the treatment of severe fungal corneal ulcer has good curative effect. The operation is simple, worthy of recommendation method. Filamentous bacterial corneal ulcer without good drug therapy effect, surgical treatment should be performed in a timely manner to improve the curative effect.