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目的:探讨带蒂球结膜瓣联合治疗翼状胬肉合并球结膜松弛症的疗效。方法:对翼状胬肉合并球结膜松弛症患者28例进行胬肉切除和下方带蒂球结膜转瓣术。手术在显微镜下操作,干净彻底清除胬肉组织,在下方球结膜制作平行角巩膜缘4mm×10mm大小、外眦端游离、内眦端带蒂的菲薄结膜瓣,游离端向下须超过胬肉宽度2mm以起拦截作用,移植片与结膜创缘对合间断缝合8～10针。结果:对28例42只眼手术后观察半年,翼状胬肉复发2只眼(复发率4.76%);眼症状改善者35只眼(83.33%);泪河恢复正常者33只眼(78.57%);泪膜破裂时间(BUT)>10s者31只眼(73.81%);裂隙灯显微镜检查眼球与下睑缘、内、外眦部之间无松弛结膜皱褶者3l眼(73.81%);下睑缘位置正常者38眼(90.48%)。结论:带蒂球结膜转瓣治疗翼状胬肉合并球结膜松弛症手术取材容易,操作简便,效果可靠,适合临床开展,是一种简单、易行、疗效好的手术选择。
Objective: To investigate the curative effect of pedicled conjunctival flap in the treatment of pterygium with bulbar conjunctivochalasis. Methods: Twenty-eight patients with pterygium and conjunctivochalasis underwent pterygium excision and pedicle conjunctival rotation. Surgical operation under a microscope, clean and completely remove the pterygium tissue, the bottom of the conjunctiva to make parallel 4-inch × 10mm size of the scleral margin, the outer end of the free, pedunculated end of the meager phlegm conjunctival flap, the free end down more than the pterygium The width of 2mm to intercept the role of graft and conjunctival wound margin of intermittent suture 8 to 10 needles. Results: Twenty-eight eyes (42 eyes) had ectopic recurrence in 2 eyes (recurrence rate: 4.76%), 35 eyes (83.33%) had ocular symptomatology, 33 eyes (78.57% ); 31 eyes (73.81%) with tear film break-up time (BUT)> 10s; 3l eyes (73.81%) without slit membrane ruffling between the eyeball and the lower eyelid, The lower eyelid position was normal in 38 eyes (90.48%). CONCLUSION: The pedicle conjunctival flap for the treatment of pterygium combined with bulbar conjunctivochalasis is easy to operate, easy to operate, reliable and suitable for clinical development. It is a simple, easy and effective surgical choice.