Application of the low-temperature plasma surgical system in pterygium excision

SUN Shan-shan; WU De; CHEN Juan; SUN Zhuo

doi:10.16048/j.issn.2095-5561.2024.01.12

Abstract：Objective To analyze the application of low-temperature plasma surgical system in pterygium excision combined with limbal stem cell autologous conjunctival transplantation and clinical effect. Methods A total of 46 cases with 54 eyes of primary pterygium patients who received surgical treatment in the Third People's Hospital of Changzhou Ophthalmology Department from March 2020 to March 2022 were retrospectively analyzed. The surgical methods were pterygium excision combined with limbal stem cell autologous conjunctival transplantation. The low-temperature plasma surgical system was used to excise the pterygium head and hemostasis during the operation.Observation indicators included the corneal epithelium healing time after the surgery,the best corrected visual acuity(BCVA) and the change of tear film function, such as Shirmer-I test(SIT),break-up time(BUT)and lacrimal river height,before and 1,3,6,12 months after the surgery. Postoperative complications and postoperative recurrence rate were observed simultaneously. Results The corneal epithelium completely healed in all eyes one week after the surgery,and the healing time was (5.7±1.0)d. Compared with preoperative,the BCVA after the surgery was improved,and BCVA at 3,6 and 12 months after the surgery was significantly improved compared with 1 month after the surgery,with statistical significance (P<0.05). There was no significant difference in BCVA at 3,6 and 12 months after the surgery(P>0.05). After the surgery,the SIT,BUT and lacrimal river height were improved compared with those before the surgery,and the SIT,BUT and lacrimal river height at 1,3,6 and 12 months after the surgery were gradually increased,with statistical significance(P<0.05). One patient had conjunctival flap necrosis and scleral lysis at 2 weeks after the surgery,and was cured after active amniotic membrane transplantation. None of the patients had recurrence after the surgery. There were 2 patients with hyperplasia of fibrous tissue in the resection area at 3 months and 6 months after the surgery, respectively,but no invasion of clear cornea. Conclusion Pterygium excision combined with autologous conjunctival transplantation with limbal stem cells can improve postoperative visual acuity,promote tear film function recovery and reduce the healing time of corneal epithelium. And furthermore, the recurrence rate is low. In pterygium excision,low-temperature plasma radiofrequency ablation can effectively achiev tissue cutting and hemostasis,minimizing intraoperative tissue damage and promoting post-surgical ocular surface environment repair and reconstruction.