两种翼状胬肉手术方式对角膜曲率影响的临床研究
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Clinical study on the effect of two surgery methods for pterygium on corneal curvature
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    摘要:

    目的:探讨单纯翼状胬肉切除与翼状胬肉切除联合角膜缘干细胞移植两种手术前后角膜曲率的改变,并比较两种手术后角膜曲率的变化差异。方法:单侧翼状胬肉38例54眼,分2组,A组单纯翼状胬肉切除术16例21眼,B组翼状胬肉切除联合角膜缘干细胞移植术22例33眼,查术前、术后10d及1mo裸眼视力、角膜曲率、散光度。结果:两组术后裸眼视力均有提高。角膜水平曲率:两组术后比术前都有显著提高。角膜垂直曲率:A组术后比术前有所提高;B组术后10d与术前无统计学差异,术后1mo比术前及术后10d均有所提高。角膜平均曲率:两组术后比术前都有显著提高。散光:两组术后10d及1mo循规性角膜散光均比术前减少。结论:翼状胬肉手术使水平径线角膜曲率回升,而垂直径线角膜曲率变化不明显。术后近期内,单纯翼状胬肉切除术和翼状胬肉切除联合角膜缘干细胞移植术对角膜曲率的影响相仿。

    Abstract:

    AIM:To study the changes of corneal curvature after simple pterygium excision and pterygium excision with limbal stem cell transplantation. METHODS:Totally 38 patients 54 eyes with pterygium were selected.They were divided into 2 groups in random:simple pterygium excision was performed in group A(16 cases and 21 eyes),pterygium excision with limbal stem cell transplantation was performed in group B (22 cases and 33 eyes).The results of visual acuity, astigmatism and corneal curvature were tested between pre-surgery and post-surgery 10 day,pre-surgery and post-surgery 1 month,post-surgery 10 day and post- surgery 1 month in both groups. RESULTS:Naked visual acuity of post-surgery was better than that of pre-surgery.Corneal horizontal curvature on post-surgery was better than that of presurgery. Corneal vertical curvature;In group A,the corneal vertical curvature of post-surgery was higher than that of pre-surgery(P<0.05).In group B,the vertical curvature on post-surgery 10 day had no statistical difference than that of pre-surgery(P>0.05),on post-surgery 1 month which was higher than that of presurgery and post-surgery 10 days(P<0.05).Corneal mean curvature on post-surgery was better than that of pre-surgery.Astigmatism:the with-the-rule keratic astigmatism on post-surgery 10 day and on post-surgery 1 month was less than that of pre-surgery. CONCLUSION:The corneal horizontal curvature in the surgeries for pterygium can be ascended which can reduce pterygium induced refractive astigmatism.In short time after surgery,the effect of simple pterygium excision is similar to the effect of pterygium excision with limbal stem cell transplantation on corneal curvature.

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王振亮,王世明,施瑜劲.两种翼状胬肉手术方式对角膜曲率影响的临床研究.国际眼科杂志, 2010,10(10):1988-1990.

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