CN103961211A - Method for treating pterygium - Google Patents
Method for treating pterygium Download PDFInfo
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- CN103961211A CN103961211A CN201410195998.5A CN201410195998A CN103961211A CN 103961211 A CN103961211 A CN 103961211A CN 201410195998 A CN201410195998 A CN 201410195998A CN 103961211 A CN103961211 A CN 103961211A
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- conjunctiva
- cornea
- bulbar conjunctiva
- polyp
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Abstract
The invention provides a method for treating pterygium, and relates to a method for treating ophthalmic diseases. The method for treating pterygium solves the problem that an existing pterygium cutting method is high in recurrence rate. Limbal stem cell transplanting is used for treating pterygium, the bulbar conjunctive at a sclera exposure area is reconstructed and repaired, local epithelial tissue at the limbus corneae is reconstructed and repaired, healthy stem cells are provided for the cornea epithelium, and the limbus corneae shielding function is reconstructed. Conjunctive epithelium and new vessels are prevented from invading the cornea. Limbal stem cell transplanting is used for treating pterygium, so that the method has the advantages that an operation is quick and safe, and reoccurrence is avoided after the operation.
Description
Technical field
The invention belongs to the method for operative treatment ophthalmic diseases, particularly a kind of method that adopts Pterygium Treated by Stem Cell Transplantation of Limbus of Cornea.
Background technology
Pterygium is one of modal oculopathy.The factors such as the generation of bulbar conjunctiva polyp and travel fatigue, smog, dry, ultraviolet are relevant.Especially ultraviolet radiation is considered to epochmaking pathogenesis.Think that at present pathogenesis may be that ultraviolet or other environment cause the damage of nose, temporo side limbal stem cell, cause stem cell barrier function destroyed, cause under conjunctiva the proliferation of fibrous tissue cornea of growing into.In addition, impaired stem cell also may discharge the vascular proliferation factor, accelerates the formation of bulbar conjunctiva polyp.Operation is the most frequently used method for the treatment of bulbar conjunctiva polyp, but simple bulbar conjunctiva polyp excision of recurrent rate is up to 24～89%.Therefore the relapse rate that, how to reduce bulbar conjunctiva polyp operation is the very big challenge that ophthalmologist faces.
Summary of the invention
The object of the invention is to overcome the shortcoming of prior art, provide one to treat pterygial method, solve the high problem of existing simple bulbar conjunctiva polyp excision of recurrent rate.
The present invention is achieved by the following technical solutions:
One is treated pterygial method, first, carries out a local anesthesia; On bulbar conjunctiva polyp head, outside lower edge, 1～2mm place cuts off bulbar conjunctiva and reaches sclera, penetrates between bulbar conjunctiva polyp and sclera with iris repositor, makes two separate, then makes cornea shallow-layer with circular knife from the transparency cornea district of the bulbar conjunctiva polyp head 0.5mm of foreign side and peels off; Bulbar conjunctiva polyp head is included and shared cornea edge, Bu Liu bulbar conjunctiva polyp remnant tissue, again bulbar conjunctiva polyp body is separated to before lacrimal caruncle, together excise together with incidence, and excise scar tissue under degeneration tissue and conjunctiva, expose smooth, smooth scleral surface, then dissecing of row superficial keratectomy pathological changes, until expose the transparency cornea tissue of below; Graft is made, inject 2% lignocaine to patient's nasal downside, subconjunctival injection on temporo, and conjunctiva is swelled, pick up a little shallow-layer conjunctiva with tooth tweezer, do not have limbus of corneae make the conjunctival flap of fascia tissue under unrelated conjunctiva and do radial cutting off, size is slightly larger than the scleral surface exposing after bulbar conjunctiva polyp excision, cutting completely before conjunctival flap, make mark suture near limbus of corneae side; The graft taking off is positioned on exposed sclera, epithelium upward, join with trouble cornea edge, graft unites by a seam conjunctiva sheet with 1% nylon wire through episclera and conjunctiva edge of wound, a pin is sewed up by limbus of corneae central authorities, does not deal with for district's wound surface, and art finishes subconjunctival injection gentamycin 20,000 units, and dexamethasone 2mg, be coated with antibiotics eye ointment.
The present invention adopts Transplanting Stem Cells of Corneal Rim, has both rebuild the bulbar conjunctiva of having repaired sclera exposed area, and the local epithelial tissue of limbus of corneae has been answered in rebuilding again, for corneal epithelium provides healthy stem cell and rebuild limbus of corneae barrier function.Stop conjunctival epithelium and new vessels to invade cornea, reached the object of curing bulbar conjunctiva polyp and preventing its recurrence.After bulbar conjunctiva polyp excision of the present invention, row limbal stem cell transplantation, rebuilds angle conjunctival surface, has reached good clinical efficacy, and non-evident effect.
Detailed description of the invention
Object:
Selection invention people carries out the patient of operation on pterygium, 35 examples (40), wherein male 14 examples, female's 21 examples, simple eye 32 examples, eyes 4 examples, 9 of recurrent pterygium 8 examples, 33～69 years old age year October in January, 2003～2006.More than all patient's pterygium heads enter the interior 3mm of cornea, in the majority with the long-term field worker of peasant.
Treat pterygial method:
First, carry out a local anesthesia, on bulbar conjunctiva polyp head, outside lower edge, 1～2mm place cuts off bulbar conjunctiva and reaches sclera, penetrates between bulbar conjunctiva polyp and sclera with iris repositor, make two separate, then make cornea shallow-layer with circular knife from the transparency cornea district of the bulbar conjunctiva polyp head 0.5mm of foreign side and peel off.Bulbar conjunctiva polyp head is included and shared cornea edge, Bu Liu bulbar conjunctiva polyp remnant tissue, again bulbar conjunctiva polyp body is separated to before lacrimal caruncle, together excise together with incidence, and excise scar tissue under degeneration tissue and conjunctiva, expose smooth, smooth scleral surface (exposed scleral surface is not burnt hemostasis in order to avoid affect postoperative Grafted healing), then dissecing of row superficial keratectomy pathological changes, until expose the transparency cornea tissue of below, it is neat, smooth that tangent plane is made every effort to, and is beneficial to the epithelial reparation of sliding.Graft is made, inject 2% lignocaine to patient's nasal downside, subconjunctival injection on temporo, and conjunctiva is swelled, pick up a little shallow-layer conjunctiva with tooth tweezer, do not have limbus of corneae make the conjunctival flap of fascia tissue under unrelated conjunctiva and do radial cutting off, size is slightly larger than the scleral surface exposing after bulbar conjunctiva polyp excision, cutting completely before conjunctival flap, make mark suture near limbus of corneae side.The graft taking off is positioned on exposed sclera, and epithelium upward, joins with trouble cornea edge, and graft unites by a seam conjunctiva sheet with 1% nylon wire through episclera and conjunctiva edge of wound.A pin is sewed up by limbus of corneae central authorities, does not deal with for district's wound surface, and art finishes subconjunctival injection gentamycin 20,000 units, and dexamethasone 2mg, is coated with antibiotics eye ointment.
Post surgery treatment:
Suffer from eye bandage pressure dressing 3, the next day, changes dressings, and after 3 days, art eye drips gentamycin collyrium, 4 times/day, within 10～14, takes out stitches.
Result:
Dry fine and smooth 35 examples (40, wherein 9 of recurrent bulbar conjunctiva polyp 8 examples) of transplanting of autologous corneal limbus, it is postoperative that no case was recurrence, more than 35 examples are followed up a case by regular visits to average December, corneal epithelium is smooth, smooth, transplanted tissue's well-grown, corneal epithelium healing, without new vessels and bulbar conjunctiva polyp hamartoplasia.
This operation note following some: (1) operation should under operating microscope, carry out; (2) bulbar conjunctiva polyp tissue must thoroughly excise.Emphasis is handled medial rectus attachment point surface and lacrimal caruncle root well.Thoroughly remove under the microscope the fiber vascular tissue of attachment point surface and front end remnants; (3) separating bulbar conjunctiva polyp head should be especially careful, avoids damaging the healthy cornea under bulbar conjunctiva polyp.(4), near rectus attachment point place, separate recurrence bulbar conjunctiva polyp and plump degeneration or cicatrix and get and front 2% lignocaine is injected in and under conjunctival epithelium, is conducive to Grafted separating making; (6) graft is sewed up while fixing, should note epithelial surface upwards, does anti-, and the limbus of corneae side of its limbus of corneae side and plant bed is matched and paved, and must be fixed on shallow table sclera to avoid postoperative graft displacement when stitching simultaneously.
The present invention's application Transplanting Stem Cells of Corneal Rim, for diseased region limbus of corneae provides healthy epithelial origin, make cornea recover the normal transparency, and provide normal epithelial stem cell for diseased region conjunctivae and selerae, thereby effectively stop abnormal conjunctiva hypertrophy, prevent pterygium recurrence.
The present invention draws materials conveniently, draws materials to come from and suffers from limbal conjunctiva on eye temporo, and after drawing materials, wound recovers good.There is no the rejection of serious complication.
In art of the present invention, as long as conscientiously careful, be unlikely damage cornea and break-through eyeball, have certain safety.Have no side effect.
The present invention's operation can be carried out in outpatient service, needn't be in hospital, and has alleviated patient burden.
In sum, the present invention's application Transplanting Stem Cells of Corneal Rim, has perform the operation quick, safety, the advantage not recurring after operation.
Claims (1)
1. the pterygial method for the treatment of, first, carries out a local anesthesia; On bulbar conjunctiva polyp head, outside lower edge, 1～2mm place cuts off bulbar conjunctiva and reaches sclera, penetrates between bulbar conjunctiva polyp and sclera with iris repositor, makes two separate, then makes cornea shallow-layer with circular knife from the transparency cornea district of the bulbar conjunctiva polyp head 0.5mm of foreign side and peels off; Bulbar conjunctiva polyp head is included and shared cornea edge, Bu Liu bulbar conjunctiva polyp remnant tissue, again bulbar conjunctiva polyp body is separated to before lacrimal caruncle, together excise together with incidence, and excise scar tissue under degeneration tissue and conjunctiva, expose smooth, smooth scleral surface, then dissecing of row superficial keratectomy pathological changes, until expose the transparency cornea tissue of below; Graft is made, inject 2% lignocaine to patient's nasal downside, subconjunctival injection on temporo, and conjunctiva is swelled, pick up a little shallow-layer conjunctiva with tooth tweezer, do not have limbus of corneae make the conjunctival flap of fascia tissue under unrelated conjunctiva and do radial cutting off, size is slightly larger than the scleral surface exposing after bulbar conjunctiva polyp excision, cutting completely before conjunctival flap, make mark suture near limbus of corneae side; The graft taking off is positioned on exposed sclera, epithelium upward, join with trouble cornea edge, graft unites by a seam conjunctiva sheet with 1% nylon wire through episclera and conjunctiva edge of wound, a pin is sewed up by limbus of corneae central authorities, does not deal with for district's wound surface, and art finishes subconjunctival injection gentamycin 20,000 units, and dexamethasone 2mg, be coated with antibiotics eye ointment.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201410195998.5A CN103961211A (en) | 2014-05-09 | 2014-05-09 | Method for treating pterygium |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201410195998.5A CN103961211A (en) | 2014-05-09 | 2014-05-09 | Method for treating pterygium |
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| CN103961211A true CN103961211A (en) | 2014-08-06 |
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| CN201410195998.5A Pending CN103961211A (en) | 2014-05-09 | 2014-05-09 | Method for treating pterygium |
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Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106011065A (en) * | 2016-07-15 | 2016-10-12 | 江苏大学 | Human eye bulbar conjunctiva pterygium stem cell strain |
-
2014
- 2014-05-09 CN CN201410195998.5A patent/CN103961211A/en active Pending
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106011065A (en) * | 2016-07-15 | 2016-10-12 | 江苏大学 | Human eye bulbar conjunctiva pterygium stem cell strain |
| CN106011065B (en) * | 2016-07-15 | 2019-08-02 | 江苏大学 | Human eye bulbar conjunctiva triangular mass of mucous membrane growing from the inner corner of the eye stem cells strain |
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Application publication date: 20140806 |