翼状片に対する新たな無切除Z型切開回転術の手術成績

Outcome of non-resection Z-shaped incision and rotation as a new surgical procedure for pterygium

要約　目的：翼状片に対して増殖組織を除去せず，頭部を移動させて有茎結膜弁移植とする無切除Z型切開回転術による手術成績の報告。

対象と方法：本研究は後ろ向き観察研究である。術後6か月以上経過観察できた翼状片30例33眼を対象とした。内訳は初発例29例32眼，再発例1例1眼，年齢は平均72.6歳，手術後観察期間は平均31.8か月であった。手術は全例において単一術者により施行された。

結果：全例で創口は良好な結膜弁にて被覆されていた。再発は2眼（6.1％）でみられたが，いずれも軽微な再発であり再手術は要していない。

結論：無切除Z型切開回転術は翼状片に対して低侵襲かつ再発率の低い有用な術式であると考えられた。

Abstract　Purpose: Non-resection Z-shaped incision and rotation for pterygium is a new operative procedure to form a fine corneal limbal wound after Z-shape excision of conjunctiva without resection of proliferative tissue. We report the clinical outcome of this surgical procedure for pterygium.

Patients and Methods: This is a retrospective observational study；33 eyes of 30 patients, who received non-resection Z-shaped incision and rotation for pterygium were enrolled. All cases were followed up for 6 months or longer. The series comprised 32 eyes of 29 cases with primary pterygia and 1 eye with recurrent pterygium. Mean age of the patients was 72.6 years（range, 51 to 90）. The follow-up period was 31.8 months on average（range, 7 to 62）. A single surgeon conducted the surgery.

Results: Corneal limbal wound has been covered with fine conjunctival tissue in all the patients. Pterygium recurred in 2 eyes（6.1％）, but no additional treatments were required until present.

Conclusion: This procedure may be considered as effective, and as a much less invasive technique than others with a low risk of recurrence.