Evaluation Of Comfort And Efficacy Of Two Pterygium Surgical Methods And Postoperative Interventions

Objective:To compared the comfort and treatment effects of two common pterygium surgical methods and postoperative interventions,and to provide a basis for clinically selecting appropriate pterygium treatment methods.Methods: Patients who were diagnosed as primary pterygium at our hospital from January 2019 to October 2019 were selected.According to the random number table method,it is divided into two groups,A and B.Group A used pterygium resection and pedicled conjunctival flap transposition,and group B used pterygium resection and autologous free conjunctival flap transplantation.According to different postoperative intervention methods,groups A and B were randomly divided into A1,A2 and B1,B2 groups,of which A1 and B1 groups were bandaged with compression bandage(removed on the first day after surgery),and A2 and B2 groups were worn a corneal contact lens postoperatively(1 week).Patients in each group were scored on the four indexes of photophobia,tearing,foreign body sensation,and pain on the 1st,3rd,5th,and 14 th days after surgery to evaluate postoperative comfort.The repair status of corneal epithelium in all patients was observed under a slit lamp,and ocular signs such as conjunctival hyperemia and degree of conjunctival edema were observed and scored.Observe and calculate the recurrence rate after 3 months.Results: A total of 71 cases(98 eyes)were included in the trial and followed up,including 37 males(54 eyes)and 34 females(44 eyes).22 patients(28 eyes)in group A1(12 males(16 eyes),10 females(12 eyes)),18 patients(30 eyes)in group A2(8 males(16 eyes),10 females(14 eyes)(Eyes)),16 cases(19 eyes)in group B1(11 cases(13 eyes)for males,5 cases(6 eyes)for females),15 cases(21 eyes)in group B2(6 cases(9 eyes)for males,9 cases for females(12 eyes)),there was no statistical difference in the basic conditions of patients in each group.1.The visual acuity of the patients in each group decreased to varying degrees in the early postoperative period(1,3,and 5 days after operation).The visual acuity gradually recovered at 14 days after operation and slightly better than that before operation.A1 group VS A2 group,B1 group VS B2 group had significant differences in visual acuity at 1d,3d,and 5d after surgery(P<0.05).It can be seen that under the same surgical methods and different postoperative interventions,the visual acuity of the contact lens group was superior in early stage In bandaged group.2.Corneal epithelial healing time in each group is:(6.04±0.962)days in group A1,(4.50±0.630)days in group A2;(6.89±0.994)days in group B1,and(4.52±1.030)in group B2.Comparison of different postoperative interventions for the same operation(Group A1 VS A2,Group B1 VS B2)revealed that there was a statistically significant difference in corneal epithelial healing time between the two groups(P <0.05).The healing time of group with postoperative corneal contact lens was lower than that in the bandage group(A1 group,A2 group).3.Evaluation of postoperative comfort of the patients: The corneal contact lens postoperatively group was more comfortable than the binding group at 1 and 3 days after operation.Different postoperative interventions with the same surgical method mainly showed different levels of photophobia and pain on the first day after operation,and different degrees of tearing on the third day after operation.The discomfort in each group gradually reduced with time,and basically disappeared after 2 weeks.4.Conjunctival signs: The score of conjunctival edema in group B2 was lower than that in group A2 on the 3rd day after surgery(P <0.05).There was no significant difference in the scores of conjunctival hyperemia and edema in the remaining groups(P> 0.05).5.The repair time of conjunctival epithelium from the free conjunctival flap was(3.79±0.976)days in group B1 and(3.33 ± 0.796)days in group B2.There was no significant difference in conjunctival repair time between the two groups(upper temporal)(P> 0.05).No complications such as infection,scleral dissolution,and corneal dissolution occurred in each group.6.Postoperative recurrence rate: In the four groups,one patient in A1 group relapsed within 3 months(recurrence rate was 3,57%),and the other three groups had no recurrence within 3 months.There was no significant difference in the recurrence rate in the groups(P= 0.296 for A1 and A2;P = 0.405 for A1 and B1).The total comparison of the A1 group with the B1 group and the A2 group with the B2 group showed that the recurrence rates of the two different surgical methods were not statistically significant(P> 0.05).Conclusion: 1.Wearing corneal contact lens after pterygium surgery can promote corneal epithelium repair,reduce conjunctival edema,and improve patients' early comfort and vision,so it is a recommended postoperative intervention.2.Pterygium resection combined with pedicled conjunctival flap transposition and pterygium resection combined with free conjunctival flap transplantation have low recurrence rates.3.Pterygium resection combined with free conjunctival flap transplantation,and wearing a corneal contact lens after surgery is a recommended treatment for pterygium.