SO SÁNH GHÉP KẾT MẠC RÌA TRÊN VÀ DƯỚI TRONG ĐIỀU TRỊ MỘNG THỊT NGUYÊN PHÁT

Thụy Lê Quang; Chức Nguyễn Hữu

Keywords:

primary pterygium, pterygium surgery, inferior limbal-conjunctival autograft transplantaion

Abstract

Purpose: To evaluate the efficacy and safety of inferior limbal-conjunctival autograft transplantaion in patients with primary pterygia.

Methods: Prospective randomised control study was carried out at Department of Ophthalmology, The Army-medical Hospital 175 from June-2018 to February-2019. 106 eyes of 90 patients with primary pterygium were randomized to undergo pterygium surgery with conjunctival autograft transplantation using either superior limbal conjunctiva (53 eyes) or inferior limbal conjunctiva (53 eyes). The patients were followed up on postoperative day 1, 3, 7 and 14; 1, 3, and 6 months.

Results: All patients were followed up for 6 months. The mean age of the patients was 51,18 ± 8,95 (range 26–66) years. Grade 1 and 3 pterygium comprised 8,5% and 16% while grade 2 pterygium comprised 75,5% of cases. Two eyes in the superior conjunctival autograft group (3.8%) and 3 eyes in the inferior conjunctival autograft group (5.7%) developed pterygium recurrence. The mean surgical time, corneal epithelial healing time, cosmetic, complications and recurrence rates required in both groups were not statistically different.

Conclusions: Pterygium excision with inferior conjunctival autograft is safe and effective. There was no statistically significant difference between the 2 groups, after excision with superior or inferior limbal conjunctival autograft.

References

Lê Văn Giang (2015), Nghiên cứu đánh giá kết quả phẫu thuật mộng thịt ghép kết mạc rìa tự thân có lót màng ối, Luận văn Tốt nghiệp Chuyên khoa 2 chuyên ngành Nhãn khoa, Đại học Y Dược Tp.HCM.

Nguyễn Công Kiệt, Nguyễn Văn Lành (2017), “Đánh giá hiệu quả phẫu thuật mộng thịt ghép kết mạc tự thân mảnh rộng cải tiến”, Tạp chí Y học Tp.HCM, 21 (1), tr.66-71.

Lê Minh Thông, Nguyễn Văn Thi (2012), “Đánh giá kết quả điều trị mộng thịt nguyên phát bằng phẫu thuật cắt mộng - xoay vạt kết mạc kết hợp áp mitomycin-C”, Tạp chí Y học Tp.HCM, 16 (1), tr.54-59.

Trần Thị Phương Thu, Nguyễn Hoàng Thụy Khanh (2012), “Đánh giá hiệu quả keo fibrin trong phẫu thuật điều trị mộng nguyên phát”, Tạp chí Y học Tp.HCM, 16 (1), tr.129-135.

Shrestha A, Shrestha A, Bhandari S, Maharjan N, Khadka D, Pant SR, Pant B P (2012), “Inferior conjunctival autografting for pterygium surgery: an alternative way of preserving the glaucoma filtration site in far western Nepal”, Clin Ophthalmol, 6 pp.315-324.

Sati Alok, Shankar Sandeep, Jha Ashok, Kalra Deepak, Mishra Sanjay, VS Gurunadh (2014), “Comparison of efficacy of three surgical methods of conjunctival autograft fixation in the treatment of pterygium”, International ophthalmology, 34 (6), pp.1233-1239.

Othman Farouk (2015), “Inferior limbal conjunctival autografting in primary pterygium”, J Egypt Ophthalmol Soc, 108 (2), pp.43-46.

Cornand G (1989), “Pterygium. Clinical course and treatment”, 66 (3-4), pp.31-108.

Janson Ben J, Sikder Shameema (2014), “Surgical management of pterygium”, The ocular surface, 12 (2), pp.112-119.

Kenyon, Kenneth R, Wagoner, Michael D, Hettinger, Michael E (1985), “Conjunctival autograft transplantation for advanced and recurrent pterygium”, Ophthalmology, 92 (11), pp.1461-1470.

Riordan-Eva P, Kielhorn I, Ficker LA, Steele AD McG, Kirkness CM (1993), “Conjunctival autografting in the surgical management of pterygium”, Eye, 7 (5), pp.634-638.

Prabhasawat Pinnita, Barton Keith, Burkett Gene, Tseng Scheffer (1997), “Comparison of conjunctival autografts, amniotic membrane grafts, and primary closure for pterygium excision”, Ophthalmology, 104 (6), 974-985.

Chen Q, Li Y, Xu F, Yan Y, Lu K, Cui L, Li M (2015), “Comparison of Inferior and Superior Conjunctival Autograft for Primary Pterygium”, Curr Eye Res, 40 (8), pp.786-877.

Yeung SN, Lichtinger A, Kim P, Elbaz U, Ku JY, Amiran MD, . . . Slomovic AR (2013), “Superior versus inferior conjunctival autografts combined with fibrin glue in the management of primary pterygia”, Cornea, 32 (12), pp.1582-1588.

Tan Donald TH, Chee Soon- Phaik, Dear Keith BG, Lim Arthur SM (1997), “Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision”, Archives of ophthalmology, 115 (10), pp.1235-1240.

Celeva Markovska Vesna, Stankovic Babic Gordana, Zdravkovska Milka (2011), “Comparative study of pterygium surgery”, Contributions, Sec. Biol. Med. Sci. MASA, 32 (2), pp.273- 287.

Chen Xiuping, Yuan Fei (2018), “Ologen Implantation versus Conjunctival Autograft Transplantation for Treatment of Pterygium”, Journal of ophthalmology, 2018