Analysis Of Clinical Efficacy Of Two Different Operations For The Primary Pterygium

Objective:To analyze the clinical efficacy of our hospital used two surgical methods in the treatment of pterygium.Methods:From October2008to October2013in the Urumqi General Hospital of lanzhou Military Region,208patients (220eyes) were accepted two kinds of operation,the one was pterygium excision combined with limbal stem cells transplantation,the other was pterygium excision combined with pedicled conjunctival flap transfer.The visual acuity, corneal epithelium repair time, basic tear secretion test (Schirmer I Test, SIT), the breaking up time (Breaking Up Time,BUT), relapse and postoperative complications were retrospectively analyzed.Results:(1)The visual acuity changes:in this study for6months pterygium patients with preoperative and postoperative best corrected visual acuity change comparative study found that A, B two groups of patients with postoperative visual acuity were obviously improved, group A improved three lines in average, group B improved2lines in average. Postoperative vision to improve A set of110eyes in78eyes (70.91%),32eyes (29.09%) did not increase;110cases of group B, postoperative visual acuity improved58eyes (52.73%), and did not improve52eyes (47.27%),the differences for the improving eyesight between two groups was statistical significant (P<0.05).(2) The corneal epithelium recovering time:the corneal epithelial healing time of the patients in group A after the operation was3.42±0.78d, group B of patients with postoperative corneal epithelial healing time was4.95±0.81d,it was longer than group A.And the comparing differences between the two groups have statistical significance (P<0.05).(3) The basic tear secretion test (SIT):3days postoperatively,the SIT were significantly increased in both groups, most of them return to normal levels in6months.There was no statistically significant difference between the groups after6months (P=0.361).(4) The BUT change:observed6months, the BUT of two groups have difference compared with preoperative.6months later by surgical treatment the BUT in the two groups is different before the surgery, and the difference has statistical significance (P=0.010).However, six months later the BUT is no difference between the two groups (P=0.182).(5) The postoperative recurrence rate:two groups of patients of postoperative has achieved obvious operation efficiently. A set of effective postoperative eye number was105, invalid number was5only, the5eyes appeard recurrence after6months.95eyes were got postoperative effective in Group B15eyes were in recurrence after6months, two groups of cases of surgical treatment for efficient comparative difference was statistical significant (P<0.05).(6)The postoperative complications:two groups of cases on the basis of different surgical procedure, postoperative complications is slightly different, points above are as follows:two groups of patients with postoperative all appear conjunctival hyperemia and edema.10cases (9.09%) in group A of patients were corneal edema,4cases (3.64%) were in dry eyes. There are26cases of group B patients (23.63%) in comeal edema,15cases (13.63%) appeared dry eyes. Two groups of patients with postoperative had no stents fall off, infections, complications, such as angle of dissolving and sclera perforation and common complication to differences between two groups have statistical significance (P0.05).Conclusion:For the primary pterygium,the Method of pterygium excision combined treatment of comeal limbus stem cell transplantation has more obvious clinical advantages than the pterygium excision combined with pedicle conjunctival flap transfer operation,such as:improve postoperative vision more apparent, ocular surface damage healing time is shorter, low recurrence rate, fewer complications and so on.In a word,it is worthy of clinical application.