A Comparison of Amniotic Membrane Allograft, Conjunctival Autograft and Primary Closure for Primary Pterygium Excision

原發性翼狀贅肉切除中比較羊膜異體移植，結膜自體移植及初級縫合之異同

吳慈恩(Tzu-En Wu) ； 王廷文(Ting-Wen Wang) ； 盧雪玉(Hsuei-Yuh Lu)

《中華民國眼科醫學會雜誌》 40卷3期 (2001/09) Pp. 243-251

https://doi.org/10.30048/ACTASOS.200109.0009

摘要

背景：本篇在探討羊膜異體移植，結膜自體移植及初級縫合在原發性翼狀贅肉切除中，何者在預防翼狀贅肉復發上有比較好的成效。
方法：本文將患者分為三組，羊膜異體移植組有27位病人，共28個患眼，平均年齡為52.3±12.5歲；初級縫合組有25位病人，共27個患眼，平均年齡為54.1±9.7歲；結膜自體移植組有30位病人，共32個患眼，平均年齡為60.9±12.8歲。每組皆進行翼狀贅肉切除，並合併羊膜或結膜自體移植至鞏膜裸露處，且以8.0 Vicryl縫線與周邊結膜縫合並固定至鞏膜上。
結果：在羊膜異體移植組，平均追蹤時間19.1±4.0個月（範圍從6至23個月），其復發率為7%；在初級縫合組，平均追蹤時間19.3±4.4個月（範圍從6至24個月），其復發率為33%；在結膜自體移植組，平均追蹤時間18.4±4.2個月（範圍從7至25個月），其復發率為3%。這三組在術後並沒有發現嚴重的併發症。由數據得知羊膜異體移植組的復發率比結膜自體移植組高，但明顯比初級縫合組低。
結論：對於原發性翼狀贅肉切除術中，合併羊膜移植可以提供一個有效的方法以預防翼肉的復發。

並列摘要

Purpose: The purpose of the study is to evaluate the effect of amniotic membrane allograft, conjunctival autograft and primary closure in the prevention of recurrence of pterygium after primary pterygium excision.
Methods: In our studies, the amniotic membrane group included 28 eyes from 27 patients (mean age, 52.3±12.5 y/o). Primary closure group included 27 eyes from 25 patients (mean age, 54.1±9.7 y/o). The conjunctival autograft group included 32 eyes from 30 patients (mean age, 60.9±12.8 y/o). After excision of pterygium, the amniotic membrane or the conjunctival autograft was transplanted to cover the exposed sclera and was secured episclerally with interrupted 8-0 Vicryl sutures.
Results: In the mean follow-up period of 19.1±4.0 months (range, 6-23 months) of the patients who receive amniotic membrane grafts, the recurrence rate was 7%. The recurrence rate of primary closure groups was 33% in the mean follow-up period of 19.3±4.4 months (range, 6-24 months). In the mean follow-up period of 18.4±4.2 months (range, 7-25 months) of the patients who received conjunctival autograft, the recurrence rate was 3%. None of these three groups suffered from severe complications. The recurrence rate of amniotic membrane grafts was higher than that of the conjunctival autograft and significantly lower than the rate of the primary closure.
Conclusions: In our clinical study, the relatively low recurrence rate of pterygium following amniotic membrane transplantation allows one to use this method as an alternative way to prevent recurrence of primary pterygium.

並列關鍵字

amniotic membrane allograft ； conjunctival autograft ； pterygium