Prospective study on amelioration of pterygium combined with free autogenous conjunctival flap transplantation for the treatment of 45 patients with primary pterygium / 中国医师杂志

ABSTRACT

Objective To explore the application effect of amelioration of pterygium combined with free autogenous conjunctival flap transplantation in patients with primary pterygium.Methods 90 cases (90 eyes) of primary pterygium treated in our hospital were grouped according to random number table.45 cases in control group were treated with traditional pterygium excision,and 45 cases in observation group were treated with pterygium combined with free autogenous conjunctival flap transplantation.The operative condition (length of operation,incision size,blood loss during operation,healing time of corneal epithelium),the effect of operation and corneal astigmatism [corneal dispersion (CAD)],naked eye [uncorrected visual acuity (UCVA)] and tear film rupture time [break up time (BUT)] before and after operation were observed and compared.The incidence of complications,recurrence rate and quality of life (SF-36) before and after operation were compared between the two groups.Results The incision size,operative time,intraoperative blood loss and corneal epithelial healing time in the observation group were smaller than those in the control group (P ＜0.05).The total effective rate of the observation group was 93.33％ (42/45),which was higher than that of the control group 75.56％ (34/45) (P ＜0.05).3 months after operation,the UCVA of the observation group was larger than that of the control group,while CAD was less than that of the control group (P ＜ 0.05).The BUT 3 months after the operation was greater than that before operation (P ＜0.05),but the difference was insignificant (P ＞ 0.05).The complication rate in the observation group was 2.22％ (1/45),which was lower than that in the control group 17.78％ (8/45) (P ＜ 0.05).The recurrence rate of the observation group was 2.22％ (1/45),which was lower than that of the control group 17.78％ (8/45) (P ＜0.05).3 months after operation,the SF-36 scores of the two groups were all higher than those before operation,and the SF-36 score of the observation group was higher than that of the control group 3 months after operation (P ＜ 0.05).Conclusions Free autogenous conjunctival flap transplantation combined with amelioration of pterygium can improve corneal astigmatism and visual function of the patients with primary pterygium,and promote corneal epithelial healing,with small incision,less bleeding and longer operation,which can reduce the incidence of postoperative complications and the recurrence rate,and help to improve the quality of life of the patients.