翼状片に対する上方結膜有茎弁移植術の術後成績

Surgical outcome for pterygium by superior conjunctival transposition flap technique

翼状片に対する手術法として，確実で十分な翼状片の切除ならびに結膜温存と移植弁の安定を図る術式を工夫し上方結膜からの有茎弁移植術を施行した。単独の術者による過去15年間の手術成績を術後6か月以上経過観察できた314例346眼について報告した。初発症例は293例325眼（年齢25～89歳，平均59歳），再発症例は21例21眼（年齢42～73歳，平均54歳）であった。再発は初発症例325眼中17眼（5.2％）および再発症例21眼中7眼（33.3％）に認め，再発までの期間は初発症例で平均4.2か月，再発症例で平均2.8か月であった。本術式は特に進行した大きな翼状片に対して有用な術式であると同時に美容的にも満足できる手術法と考える。

The authors modified surgical techinique for pterygium excision with superior conjunctival transposition flap to obtain the complete and secure removal of pterygium,to preserve the conjunctiva as much as possible and to stabilize the translocated flap. We reviewed the outcome of this surgical procedure for pterygium in 346 eyes of 314 patients during the 15 years. All the patients were treated by one surgeon and had 6 months or more of follow-up period. The series comprised 325 eyes of 293 cases（mean age 59 years,range 25 to 89 years）with primary pterygia and 21 eyes of 21 cases（mean age 54 years,range 42 to 73 years）with recurrent pterygia. 17 out of 325 eyes（5.2％）of primary pterygia recurred while 7 out of 21 eyes（33.3％）of recurrent pterygium group recurred. These recurrences occurred within 3 to 6 months（average 4.2 months）in primary pterygia and within 2 to 3 months（average 2.8 months）in recurrent pterygia. The authors recommend this procedure as effective means of treating pterygia with good anatomic and cosmetic results and useful technique for advanced large pterygium.