目的:比较羊膜移植联合丝裂霉素C(mitomycin C,MMC)与羊膜移植在翼状胬肉治疗中的有效性和安全性。方法:我们进行Meta分析进行比较。计算机扩大检索Cochrane图书馆,MEDLINE,EMBASE,CBMdisc,CNKI.等数据库获得数据。通过Cochrane协作网提供的RevMan4.2软件进行数据统计分析。结果:羊膜移植联合MMC显著降低了翼状胬肉的复发率。但是否会增加术后的并发症仍需更多的临床试验证实。入选的6项临床试验均报道了翼状胬肉术后的复发率,包括882眼,3项临床试验报道了术后并发症情况。Meta分析的结果显示羊膜移植联合MMC组复发率为5.41%,只进行羊膜移植组复发率为16.89%,相对危险度为0.32,95%可信区间为0.19～0.56,Z值为4.06,P<0.001。2项研究报道了术后早期点状角膜炎的发生情况,羊膜移植联合MMC组与羊膜移植组的发病率分别为17.14%和0.00%,相对危险度为12.11,95%可信区间为1.62～90.76。结论:与羊膜移植相比,羊膜移植联合MMC联合治疗翼状胬肉显著降低了术后复发率。

AIM:To evaluate the recurrence rate and safety of amniotic membrane transplantation (AMT) augmented with mitomycin C (MMC) compared with amniotic membrane transplantation alone during the pterygium excision. ·METHODS:We took a meta-analysis on this program. Pertinent studies were selected through extensive searches of the Cochrane Library,MEDLINE,EMBASE,CBMdisc,CNKI. Pooled estimates were carried out in RevMan software V4.2. ·RESULTS:Six trials reported postoperative recurrence rate of pterygium,included 882 eyes,three trials reported the complications. The results of meta-analysis showed that recurrence rate of AMT plus MMC group was 5.41%,AMT alone group was 16.89%,relative risk(RR) was 0.32,95%CI ranged from 0.19 to 0.56,Z was 4.06,P<0.001. Two trials reported early complication as punctata keratitis,the incidence rate of AMT plus MMC group and AMT alone group were 17.14% and 0.00%,RR was 12.11,95%CI ranged from 1.62 to 90.76. ·CONCLUSION:Amniotic membrane transplantation with MMC is associated with lower recurrence rate compared with amniotic membrane transplantation alone in pterygium excision,whether accompanied a higher risk with adverse events need more investigation.

R779.6