方法：观察2010-12/2012-12在我院确诊为鼻侧翼状胬肉合并结膜松弛症患者30例46眼，年龄49～75(平均61.2±7.2)岁，在鼻侧翼状胬肉切除后，于下方角膜缘取一块与切除区域大小一致，带角膜缘干细胞结膜瓣，移植到翼状胬肉切除后巩膜面暴露区，修整下方球结膜，再将球结膜固定于下方角膜缘及巩膜面。术后随访1a，比较术前和术后1mo的视力变化，以及术前和术后3mo眼表泪液动力学方面的变化，包括泪河线高度及完整性、泪膜破裂时间、荧光素活体染色、氯霉素尝味试验，统计手术并发症及术后1a复发率等。

结果：患者术前视力0.04～0.6，中位数0.2； 术后1mo视力0.04～1.0，中位数0.4。术后46眼视力提高21眼(45.7%)，无变化25眼(54.3%)。术后与术前视力比较差异有统计学意义(P<0.01)。术后3mo泪膜破裂时间、荧光素活体染色、氯霉素尝味试验、泪河线高度及完整性均较术前改善，差异有统计学意义(P<0.01)。术后随访1a，翼状胬肉痊愈33眼(71.7%)，显效11眼(23.9%)，总有效率95.6%，无效2眼(4.4%)，为胬肉复发，复发率4.4%。结膜松弛症主观疗效评价治愈33眼(71.7%)，改善9眼(19.6%)，4眼(8.7%)自觉无明显改善，总有效率91.3%； 客观疗效评价手术区结膜正常41眼(89.1%)，异常5眼(10.9%)，为结膜松弛症复发，复发率10.9%。未发现肉芽增生、下穹隆缩窄、眼球运动障碍等并发症。

结论：下方角膜缘干细胞移植治疗翼状胬肉合并结膜松弛症能有效提高患者术后视力，并消除或缓解患者临床症状，改善眼表泪液动力学，是一种有效的治疗方法。

METHODS: All 30 patients(46 eyes)diagnosed as pterygium combined with conjunctivochalasis in our hospital from December, 2010 to December, 2012 with a mean age of 61.2y(SD 7.2, range 49-75)were subjected to observation. After excision of nasal pterygium, an equivalent size of conjunctival flap linked with corneal limbal stem cell from inferior limbus was transplanted to the exposed sclera. Afterwards, the inferior bulbar conjunctiva was trimmed and fixed onto surface of sclera and inferior corneal limbus. After one-year follow-up, the comparisons regarding vision acuity between pre-operation and post-operation(1mo later)as well as ocular-surface tear dynamics changes including several indexes like altitude and integrity of tear meniscus, break-up time(BUT), corneal fluorescein staining and chloramphenicol gestation test before and 3mo after surgery were made. The operative complications and the recurrence rates 1y after operations were recorded.

RESULTS: Median visual acuity was 0.2(0.04-0.6)before the operation and median visual acuity was 0.4(0.04-1.0)1mo after the operation. Of total 46 eyes in 21 eyes(45.7%), visual acuity improved. No vision changes were found in other 25 eyes(54.3%). Significant difference(P<0.01)of vision acuity before and after surgery was found. In addition, break-up time(BUT), corneal fluorescein staining and chloramphenicol gestation test and altitude and integrity of tear meniscus show better results 3mo after surgery than that of pre-operation, which showed statistically significant(P<0.05). After 1y follow-up, 33 eyes(71.7%)healed while problems in 11 eyes(23%)were relieved. The total efficacy rate was 95.6%. Nonetheless, invalid surgeries were noticed in two eyes(4.4%)that affected by recurrence of pterygium. The 33 eyes(71.7%)affected by conjunctivochalasis was cured in terms of subjective evaluation and improved in 9 eyes(19.6%), but 4 eyes(8.7%)exhibited no evident improvement in terms of subjective complains. Total efficacy was 91.3%. The 41 eyes(89.1%)were reported to be normal while 5 eyes(10.9%)were revealed to be abnormal in terms of objective therapeutic evaluation. And this condition was so-call conjunctivochalasis recurrence with a recurrence rate of 10.9%. No proliferation of granulation, narrowing inferior fornix and malfunction of eye movements was found.

CONCLUSION: Inferior-limbal-stem-cell transplantation to treat pterygium combined with conjunctivochalasis obtains better results. It proves to eradicate or relieve symptoms of patients effectively and ameliorate ocular-surface tear dynamics.