自己結膜弁移植と羊膜を用いた片側および両側初発翼状片の治療成績

Outcome of conjunctival autograft and transplantation of amniotic membrane for primary single and double pterygium

要約　目的：当科での翼状片に対して行った手術の成績の報告。対象と方法：術後6か月以上経過観察できた，瞳孔領に及ぶ初発翼状片13例14眼を対象とした。片側9眼，両側5眼で，男性9眼，女性5眼であり，平均年齢は57歳であった。全例に翼状片切除，有茎結膜弁移植，羊膜移植を行った。結果：術後6か月の平均視力は，片側例で有意に改善し（p＜0.05），膜乱視の平均値は，両側例で有意に減少した（p＜0.05）。両側例2眼（14％）で翼状片が再発し，これら2眼では大きさと厚みのスコア合計が大きかった。結論：広範囲な翼状片に対し，切除，自己有茎結膜弁移植，羊膜移植による手術法は有効であった。

Abstract.　Purpose：To report the outcome of conjunctival autograft and transplantation of amniotic membrane for single and double pterygium. Cases and Method：This retrospective study was made on 14 eyes of 13 cases who received surgery for primary pterygium. All pterygia reached pupillary 3 one, and all cases were followed up for at least 6 months. Pterygium was single in 9 eyes and double in 5 eyes. The series comprised 9 males and 5 females. The age averaged 57 years. All the eyes received resection of ptereygium, conjunctival autograft, and transplantation of amiotic membrane. Results：Averaged visual acuity at 6 months improved in eyes with single pterygium（p＜0.05）. Averaged value of corneal astigmatism at 6 months decreased in eyes with double pterygium（p＜0.05）. Pterygium recurred in 2 eyes（14％）. These two eyes had double pterygium with high values for size and thickness. Conclusion：Advanced single or double pterygium was effectively treated by excision, conjunctival autograft and transplantation of amniotic membrane.