方法：前瞻性对照研究。选取2015-10/2019-10于我院接受治疗的翼状胬肉患者102例102眼，按随机数字表法分为两组：对照组行翼状胬肉切除联合羊膜移植术治疗51眼，观察组行翼状胬肉切除联合自体带角膜缘上皮的球结膜移植术治疗51眼。比较两组患者术中失血量、手术时间、角膜上皮修复时间及术后3mo临床疗效，并记录手术前后泪膜破裂时间(BUT)、裸眼视力(UCVA)、泪液分泌试验(SⅠt)、角膜散光度(CAD)变化情况，以及术后治疗美学量表评分比较和随访过程中的复发情况。

结果：观察组患者角膜上皮修复时间短于对照组(4.14±1.35 vs 4.72±1.37d，P<0.05)，手术时间长于对照组(32.24±6.69 vs 29.67±5.21min，P<0.05)，而两组术中失血量比较无差异(P>0.05)； 术后3mo，两组患者治疗有效率比较无差异(86.3% vs 78.4%，P>0.05)，BUT、UCVA、SⅠt较术前均显著上升(均P<0.05)，且观察组UCVA、SⅠt显著高于对照组(均P<0.05)，两组BUT比较无差异(P>0.05)，两组CAD较术前均显著下降(均P<0.05)，但组间比较无差异(P>0.05)； 术后3mo，观察组翼状胬肉治疗美学量表中眼部恢复、自觉症状评分均显著高于对照组(均P<0.05)，而两组间术区清洁及充血情况评分比较无差异(均P>0.05)； 两组随访期间的复发率比较无差异(P>0.05)。

结论：翼状胬肉切除联合自体带角膜缘上皮的球结膜移植术可有效治疗翼状胬肉，防止复发，相比于翼状胬肉切除联合羊膜移植术，患者术后恢复更快，美观度更佳。

METHODS:Prospective controlled study. A total of 102 patients(102 eyes)with pterygium treated in the hospital between October 2015 and October 2019 were selected as study subjects, and they were divided into observation group and control group according to the random number table method, with 51 cases in each group. The control group was treated with pterygium excision combined with amniotic membrane transplantation, and the observation group was given pterygium excision combined with autologous limbal epithelial bulbar conjunctival transplantation. The perioperative indicators(intraoperative blood loss, surgical time, corneal epithelial repair time)and clinical efficacy at 3mo after surgery were compared between the two groups, and the disease recovery-related indicators \〖tear film break-up time(BUT), uncorrected visual acuity(UCVA), Schirmer Ⅰ test(SⅠt), corneal astigmatism degree(CAD)\〗 before and 3mo after surgery, postoperative aesthetic degree and recurrence during follow-up were recorded.

RESULTS:The corneal epithelial repair time in observation group was shorter than that in control group(4.14±1.35 vs 4.72±1.37d,P<0.05), while the surgical time was longer than that in control group(32.24±6.69 vs 29.67±5.21min,P<0.05), and there was no statistical significance in the intraoperative blood loss between the two groups(P>0.05). At 3mo after surgery, there was no statistical difference in the effective rate of treatment between the two groups(86.3% vs 78.4%, P>0.05). At 3mo after surgery, the BUT, UCVA and SⅠt in the two groups were significantly enhanced compared with those before surgery(all P<0.05), and the UCVA and SⅠt in observation group were higher than those in control group(all P<0.05), but there was no statistical difference in the BUT between the two groups(P>0.05). The CAD in the two groups was significantly lower than that before surgery(P<0.05), but the difference was not significant between the groups(P>0.05). At 3mo after surgery, the scores of dimensions of aesthetic scale for pterygium treatment(ocular recovery, subjective symptoms)were significantly higher in observation group than those in control group(all P<0.05), but there were no statistical differences in the scores of cleanliness of surgical area and congestion between the two groups(all P>0.05). There was no statistically significant difference in recurrence rate between the two groups during follow-up(P>0.05).

CONCLUSION: Pterygium excision combined with autologous limbal epithelial bulbar conjunctival transplantation can effectively treat pterygium and prevent recurrence, and it has faster postoperative recovery and better aesthetic degree compared to pterygium excision combined with amniotic membrane transplantation.