翼状片の再発率に影響する諸要因

Factors affecting post surgical recurrence of pterygium

　1983年までの2年間に742例の翼状片手術がなされ，全例に翼状片切除に強膜露出と，結膜有茎弁移植を併用した同一の術式が採用された．

　再発は初回手術608例の160例（26％），2回手術60例の29例（48％），3回手術7例の6例（86％）にみられ，再発率は手術回数と共に著しく増加した．また，30歳以下の若年者，三つ以上の多数の翼状片を持つ症例，術後に肉芽腫が続発する症例においては，再発率が有意に高率であった．

　一定期間以上の経過観察ができない脱落例数の累計は時と共に増加し，これと相関して再発率も上昇するので，手術成績の統計的指標には，単に再発率のみならず脱落例数も考慮する必要があると考えられた．

　120例の比較対象の結果，術後のステロイド点眼には，再発を減少させる効果はなかった．

We performed pterygium surgery on 608 eyes during a 2-year-period. A standardized surgical technique was employed in all the cases by excision of pterygium, baring of the sclera and transposition of the conjunctiva.

The postsurgical rate of recurrence increased after repeated surgeries. Recurrence developed in 160 out of 608 eyes (26%) after first surgery, in 29 out of 60 eyes (48%) after two surgeries and in 6 out of 7 eyes (86%) after three. There was a significant tendency for recur-rence to develop in subjects of 30 years or less in age, inpatients with a total of three pterygia or more in both eyes, and in eyes that developed postsurgical granuloma. We evaluated the possible beneficial effect of topical 0.1% dexamethasone 6 times a day during the four postsurgical weeks in 60 eyes with another 60 eyes as control. There was no difference in the rate of recur-rence of pterygium between the two groups.

Rinsho Ganka (Jpn J Clin Ophthalmol) 40 (8) : 961-965,