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目的:研究低浓度丝裂霉素在翼状胬肉治疗中的有效性和安全性。方法:前瞻、随机、对照临床试验,将确诊为翼状胬肉的400例患者550眼随机分为4组—第一组:100例患者的130眼,不使用丝裂霉素;第二组:100例患者的140眼,使用0.2g/L丝裂霉素;第三组:100例患者的150眼,使用0.3g/L丝裂霉素;第四组:100例患者的130眼,使用0.4g/L丝裂霉素。每组接受暴露巩膜的原发性翼状胬肉切除术。入选当天以及术后2wk;2,6mo;1a分别记录患者的视力、眼压、眼球运动、虹睫炎、疤痕、症状(流泪、畏光、异物感)和体征(结膜充血、角巩膜溃疡和巩膜穿孔)。结果:第三组和第四组的翼状胬肉术后复发率明显低于第一组和第二组(P<0.01)。术后第四组的眼压升高、虹睫炎、症状和体征的发生明显高于第一、二、三组。结论:低浓度丝裂霉素在预防翼状胬肉术后复发的治疗中是有效的。它的有效性随着浓度的增加而增加,同时,它的安全性随着浓度的增加而下降。
Objective: To study the efficacy and safety of low concentration of mitomycin in the treatment of pterygium. METHODS: In a prospective, randomized, controlled clinical trial, 550 eyes of 400 patients diagnosed with pterygium were randomized into 4 groups - Group 1: 130 eyes in 100 patients without mitomycin; Group 2: 140 eyes of 100 patients with 0.2 g / L mitomycin; Group 3: 150 eyes of 100 patients with 0.3 g / L mitomycin; Group IV: 130 eyes with 100 patients, 0.4g / L mitomycin. Each group received primary pterygium excision of the exposed sclera. The patient’s visual acuity, intraocular pressure, eye movement, rainbow eyelashes, scarring, symptoms (tearing, photophobia, foreign body sensation) and signs (conjunctival hyperemia, scleral ulcer and Scleral puncture). Results: The recurrence rates of the third and fourth groups were significantly lower than those in the first and second groups (P <0.01). The intraocular pressure increased in the fourth group after operation, and the incidence of symptoms and signs of rhinocerositis was significantly higher than that of the first, second and third groups. Conclusions: Mitomycin at a low concentration is effective in preventing the recurrence of pterygium surgery. Its effectiveness increases with increasing concentration and at the same time its safety decreases with increasing concentration.