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[Clinical observation of therapeutic efficacy and study of conjunctival impression cytology after pterygium surgery].

OBJECTIVE
To compare the pathologic changes, the recurrence rate and the ocular surface damage after 4 different types of pterygium surgical procedures.


METHODS
It is a prospective study. From Mar. 2006 to Mar. 2008, 84 patients (93 eyes) from Shi Jia-zhuang Center Hospital were selected and separated into 4 groups as follows, simple excision group, 24 patients (27 eyes); excision with conjunctival allograft group, 21 patients (22 eyes) excision with autologous limbus stem cell transplantation group, 18 patients (20 eyes) and excision with mitomycin (MMC) group, 21 patients (24 eyes). Slit lamp microscope examination and impression cytology were performed 1 day before the surgery and repeated 30 and 90 days after the surgery. Multivariate analysis of variance was used to analyze these data with statistical software SPSS 11.0. P value less than 0.05 was considered statistically significant.


RESULTS
Before the surgery, slight conjunctival epithelium keratinization, mild acantholysis and decrease in goblet cells density were identified in all patients (248.8 +/- 97.3, 256.2 +/- 75.1, 236.1 +/- 87.9, 245.1 +/- 81.0; F = 0.029, P = 0.993). All of these changes decreased 1 month after the surgery. MMC group showed more goblet cells than the other 3 groups, but the difference was not statistically significant (F = 0.747, P = 0.554). Three months after the surgery, all of these changes in MMC group (112.1 +/- 56.8) were significantly more severe than those in other 3 groups (309.6 +/- 77.0, 314.1 +/- 68.9, 317.4 +/- 73.2; F = 6.337, P = 0.017) and no difference could be detected between these 3 groups. There were 5 recurrences in simple excision group, 3 recurrences in MMC group, 1 recurrence in stem cell transplantation group and none in conjunctival allograft group.


CONCLUSIONS
There are fewer recurrent cases in conjunctival allograft group and stem cell transplantation group than the others. Severe ocular surface damage is present in MMC group.