臨床眼科76巻13号

2022年12月発行

連載 今月の話題

翼状片—今，考えるべきこと

著者： 宮田和典¹

所属機関： ¹宮田眼科病院

ページ範囲：P.1631 - P.1638

　翼状片は比較的軽症の疾患と軽視されがちであるが，角膜表面にあるため，視機能に与える臨床的影響は大きい。また，再発すると周辺組織と癒着して，視機能障害に加えて眼球運動障害を生じることや，悪性化して再発を繰り返すことも稀ではない。翼状片という疾患の特性を十分理解した治療方針を立てるべきである。

参考文献

1）Tan DT, Chee SP, Dear KB et al：Effect of pterygium morphology on pterygium recurrence in a controlled trial comparing conjunctival autografting with bare sclera excision. Arch Ophthalmol 115：1235-1240, 1997

2）Kaya M, Tunç M：Vertical conjunctival bridge flaps in pterygium surgery. Ophthalmic Surg Lasers Imaging 34：279-283, 2003

3）Kilic A, Gurler B：The efficiency of limbal conjunctival autografting in pterygium surgery. Eur J Ophthalmol 16：365-370, 2006

4）Ozer A, Yildirim N, Erol N et al：Long-term results of bare sclera, limbal-conjunctival autograft and amniotic membrane graft techniques in primary pterygium excisions. Ophthalmologica 223：269-273, 2009

5）Cano-Parra J, Diaz-Llopis M, Maldonado MJ et al：Prospective trial of intraoperative mitomycin C in the treatment of primary pterygium. Br J Ophthalmol 79：439-441, 1995

6）Panda A, Das GK, Tuli SW et al：Randomized trial of intraoperative mitomycin C in surgery for pterygium. Am J Ophthalmol 125：59-63, 1998

7）Yanyali AC, Talu H, Alp BN et al：Intraoperative mitomycin C in the treatment of pterygium. Cornea 19：471-473, 2000

8）Frucht-Pery J, Raiskup F, Ilsar M et al：Conjunctival autografting combined with low-dose mitomycin C for prevention of primary pterygium recurrence. Am J Ophthalmol 141：1044-1050, 2006

9）増田綾美・高橋幸輝：子島良平・他：初発翼状片1,832眼に対する術中マイトマイシンCを併用した有茎結膜弁移植術の検討．日眼会誌117：743-748，2013

10）Nejima R, Masuda A, Minami K et al：Topographic changes after excision surgery of primary pterygia and the effect of pterygium size on topograpic restoration. Eye Contact Lens 41：58-63, 2015

11）Zloto O, Greenbaum E, Fabian ID et al：Evicel versus tisseel versus sutures for attaching conjunctival autograft in pterygium surgery. Ophthalmology 124：61-65, 2017

12）Maiti R, Mukherjee S, Hota D：Recurrence rate and graft stability with fibrin glue compared with suture and autologous blood coagulum for conjunctival autograft adherence in pterygium surgery：a meta-analysis. Cornea 36：1285-1294, 2017

13）Busin M, Halliday BL, Arffa RC et al：Precarved lyophilized tissue for lamellar keratoplasty in recurrent pterygium. Am J Ophthalmol 102：222-227, 1986

14）Laughrea PA, Arentsen JJ：Lamellar keratoplasty in the management of recurrent pterygium. Ophthalmic Surg 17：106-108, 1986

15）Mutlu FM, Sobaci G, Tatar T et al：A comparative study of recurrent pterygium surgery：limbal conjunctival autograft transplantation versus mitomycin C with conjunctival flap. Ophthalmology 106：817-821, 1999

16）Shimazaki J, Kosaka K, Shimmura S et al：Amniotic membrane transplantation with conjunctival autograft for recurrent pterygium. Ophthalmology 110：119-124, 2003

17）Hirst LW：Recurrent pterygium surgery using pterygium extended removal followed by extended conjunctival transplant：recurrence rate and cosmesis. Ophthalmology 116：1278-1286, 2009

18）Katırcıoglu YA, Altiparmak U, Engur Goktas S et al：Comparison of two techniques for the treatment of recurrent pterygium：amniotic membrane vs conjunctival autograft combined with mitomycin C. Semin Ophthalmol 30：321-327, 2015

19）Shimazaki J, Shinozaki N, Tsubota K：Transplantation of amniotic membrane and limbal autograft for patients with recurrent pterygium associated with symblepharon. Br J Ophthalmol 82：235-240, 1998

20）Miyai T, Hara R, Nejima R et al：Limbal allograft, amniotic membrane transplantation, and intraoperative mitomycin C for recurrent pterygium. Ophthalmology 112：1263-1267, 2005

21）Ono T, Mori Y, Nejima R et al：Long-term follow-up of transplantation of preserved limbal allograft and amniotic membrane for recurrent pterygium. Graefes Arch Clin Exp Ophthalmol 254：2425-2430, 2016

22）Tan DT, Lim AS, Goh HS et al：Abnormal expression of the p53 tumor suppressor gene in the conjunctiva of patients with pterygium. Am J Ophthalmol 123：404-405, 1997

23）Solomon A, Grueterich M, Li DQ et al：Overexpression of insulin-like growth factor-binding protein-2 in pterygium body fibroblasts. Invest Ophthalmol Vis Sci 44：573-580, 2003

24）Peiretti E, Dessì S, Mulas MF et al：Fibroblasts isolated from human pterygia exhibit altered lipid metabolism characteristics. Exp Eye Res 83：536-542, 2006

25）宮田和典：眼科手術のサイエンス：前眼部手術のsustainabilityを考える—今日のデータを明日のために．日眼会誌121：249-290，2017

26）Tomidokoro A, Miyata K, Sakaguchi Y et al：Effects of pterygium on corneal spherical power and astigmatism. Ophthalmology 107：1568-1571, 2000

27）Tomidokoro A, Oshika T, Amano S et al：Quantitative analysis of regular and irregular astigmatism induced by pterygium. Cornea 18：412-415, 1999

28）Minami K, Miyata K, Otani A et al：Detection of increase in corneal irregularity due to pterygium using Fourier series harmonic analyses with multiple diameters. Jpn J Ophthalmol 62：342-348, 2018

29）Miyata K, Minami K, Otani A et al：Proposal for a novel severity grading system for pterygia based on corneal topographic data. Cornea 36：834-840, 2017

30）宮田和典・子島良平・森　洋斉・他：翼状片の進展率に基づく重症度分類の検討．日眼会誌122：586-592，2018

31）Nejima R, Masuda A, Minami K et al：Topographic changes after excision surgery of primary pterygia and the effect of pterygium size on topograpic restoration. Eye Contact Lens 41：58-63, 2015

32）Shiotani Y, Maeda N, Inoue T et al：Comparison of topographic indices that correlate with visual acuity in videokeratography. Ophthalmology 107：559-564, 2000