原發性及復發性翼狀贅片以自體結膜移植手術治療之經驗

翼狀贅片復發是個眼科常見的困擾，一般行鞏膜露出術後多會給予mitomycin-C，Thiotepa或Beta照射來減少其後發，然復發之病例仍是不少，過去即有數位學者報告過以結膜瓣移植術對復發效果較佳。本文以自體結膜移植術來治療復發性或較厲害原發性真狀贅片做一報告。共20位病人，22隻患眼，原發性3眼，復發性18眼，另有一眼為假性真狀贅片，開過一次刀。復發性病例中，14眼先前做過一次手術，4眼二次手術。術前有一位病人兩眼均為復發性，眼球運動有困難，且有結膜粘合，另有2眼有輕度眼球運動困難。手術方法先做鞏膜與內直肌露出後，取片上方球結膜來覆蓋。術後追踪由2.5月至19月，平均十月，復發有二眼，均為同一病人，此病人術前其復發長勢就很厲害，術後仍有眼球運動困難，其餘先前有輕度眼球運動困難者均得改善。術後除有異物感外無任何不適。所有移植結膜均能存活，移植結膜在術後會浮腫充血，4至5天時有附近血管進入，之後移植結膜浮腫漸消退，顏色恢復正常。

關鍵字

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並列摘要

22 eyes of 20 patients with pterygium were treated with Conjunctival autograft transplantation. 3 eyes were advanced primary, 18 eyes were recurrent and 1 eye suspected of pseudopterygium with recurrence after excision. In cases of recurrent pterygia, 14 eyes received one operation and 4 eyes had twice operations before. All these patients were treated with conjunctival autograft transplantation. A thin conjunctival graft was excised from upper temporal bulbar conjunctiva to cover the bare sclera and rectus muscle. Postoperative follow up length ranged from 2.5 to 19 months (mean: 10 months). All the graft were survival. There were 2 eyes of recurrence in a same patient. He had severe abduction limitation, aggressive recurrent pattern and symblepharon before operation. 2 months after operation, he got recurrence of both eyes again. 2 eyes of mild abduction limitation got improvement after operation. All the conjunctival grafts became edematous and congested after operation. In 4 to 5 days, vascularization from peripheral conjunctiva grew into. The color of conjunctival graft turned to normal appearance gradually. Conjunctival graft transplantation was originally treated for primary pterygia to prevent recurrence. Certainly, in primary advanced and recurrent pterygia, it is a good choice of treatment.

並列關鍵字

Pterygium ； bare sclera ； Conjunctival autograft transplantation ； Recurrent pterygium

國際替代計量

原發性及復發性翼狀贅片以自體結膜移植手術治療之經驗

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