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目的探讨自体健眼角膜缘干细胞移植治疗巨大翼状胬肉术后泪膜功能的变化。方法接受自体健眼角膜缘干细胞移植治疗巨大翼状胬肉患者31例31眼,通过全面检查,排除糖尿病、甲状腺功能亢进、类风湿性关节炎、睑板腺功能障碍等,影响泪膜功能的疾病,记录术前及术后30 d、60 d、90 d基础泪液分泌实验(SIt)、泪膜破裂时间(BUT)、角膜荧光素染色(FL)的结果。术前患眼与健眼对照,术后不同时间结果与术前对照。结果术前患眼与健眼比较:患眼的SIt明显减少,BUT明显缩短,FL评分明显高于健眼,差异具有统计学意义(P<0.01)。患眼手术前后比较:术后30 d,3项检测结果与术前无统计学意义(P>0.05);术后60 d,SIt比术前增加(P<0.01),BUT明显延长(P<0.01),FL评分比术前显著降低(P<0.01),与健眼相比,SIt接近健康水平(P>0.05),BUT及FL评分仍有差异(P<0.01);术后90 d,3项检测结果已恢复至健眼水平(P>0.05)。结论巨大翼状胬肉切除自体健眼角膜缘干细胞移植术,可使患眼泪膜功能得到很大程度的改善。
Objective To investigate the changes of tear film function after autologous corneal limbal stem cell transplantation for giant pterygium surgery. Methods Thirty-one patients (31 eyes) with giant pterygium treated by autologous healthy limbal stem cell transplantation were treated with a complete examination to exclude diseases such as diabetes mellitus, hyperthyroidism, rheumatoid arthritis, meibomian gland dysfunction, and tear film function The basal tear secretion test (SIt), tear film breakup time (BUT) and corneal fluorescein staining (FL) were recorded preoperatively and 30 days, 60 days and 90 days after operation. Preoperative eye and eye health control, postoperative results at different times with preoperative control. Results Compared with preoperative eye and healthy eye: SIt decreased significantly, BUT significantly shortened, FL score was significantly higher than healthy eye, the difference was statistically significant (P <0.01). There was no significant difference between preoperative and postoperative eyes on the 30th day after operation (P> 0.05). At 60 days after operation, the SIt was significantly higher than preoperative (P <0.01) and BUT was significantly longer (P < 0.01). The score of FL was significantly lower than that before operation (P <0.01), SIt was close to healthy level (P> 0.05) Three test results have returned to healthy eye level (P> 0.05). Conclusion The huge pterygium excision of autosomaltic limbal stem cell transplantation can make the tear film function to a great extent.