マイトマイシンCおよび結膜弁移植を行わない翼状片手術の再発率

Rate of recurrence after pterygium surgery without mitomycin C or conjunctival autograft

目的：翼状片に対する手術成績の報告。対象と方法：過去3年間に翼状片手術を行った126例157眼を対象とし，6か月以上，平均17.9か月の経過を観察した。筆者らのうち3名が所属する医療機関での手術手技を用い，結膜下の増殖組織を広範囲に切除し結膜を温存する単純切除を行った。輪部を越えて角膜に侵入する血管新生を再発と定義した。結果：観察期間中に3眼（1.9％）に翼状片が再発した。結膜上皮欠損は4.5±1.3日で治癒した。合併症として，眼球運動時の違和感が5眼，内眼角部の肉芽腫形成が2眼にあった。結論：翼状片に対する単純切除法は再発率が高いとされているが，広範囲結膜下増殖組織の切除を行う術式で高い治癒率が得られた。

Purpose：To report the outcome of pterygium surgery. Cases and Method：This study involved 157 eyes of 126 patients who underwent pterygium surgery during the past 3 years. They were followed up for 6 months or longer,average 17.9 months. We used the surgical technique that has been practised in the institution of three of the current authors. It consists of simple excision of pterygium,extensive removal of subconjunctival proliferated tissue,and leaving the conjunctiva epithelium intact. We did not use mitomycin C nor conjunctival autograft as adjunct to surgery. Recurrence was defined as neovascularization into the cornea. Results：Pterygium recurred in 3 eyes（1.9％）during the period of observation. Conjunctival epithelial defect healed after an average of 4.5±1.3 days. As major complications,there were 5 eyes of foreign body sensation during eye movement. Granuloma developed at the site of caruncle in 2 eyes. Conclusion：Contrary to the accepted view regarding pterygium surgery,simple resection with extensive removal of proliferated tissue beneath the pterygium resulted in very low rate of recurrence in the present series.