Pterygia are common conjunctival degenerations with well-documented risk factors but an unclear pathogenesis. Better understanding of the pathogenesis of pterygium could lead to improved surgical outcomes and decreased postoperative recurrence. Currently, pterygium excision with conjunctival autograft remains the preferred surgical technique to decrease pterygium recurrence. Many adjuvant therapies have been used in pterygium surgery to varying degrees of success. Topical cyclosporine, an immunosuppressive medication, in conjunction with conjunctival autograft was found to be most successful in decreasing pterygium recurrence according to a recent meta-analysis. Other adjuvant therapies such as mitomycin-C (MMC), 5-fluorouracil (5-FU), and beta-irradiation have also been used, though usage of these may cause multiple adverse effects. Recent research indicates that interactions between mouse double minute 2 (MDM2) and p53 could play a role in the occurrence of pterygium. Nutlin, an MDM2 antagonist, was found to have significantly less toxicity in conjunctival cells when compared with MMC on laboratory analysis of pterygium samples.
摘要: 翼状胬肉为常见的结膜退行性病变, 危险因素明确, 但发病机制仍尚不清楚。深入了解翼状胬肉的发病机制可助于提高手术疗效, 减少术后复发。目前, 翼状胬肉切除联合自体结膜移植术仍是减少翼状胬肉复发的首选手术方法。许多辅助性治疗已在翼状胬肉的切除术中获得了不同程度的成功。根据最近的荟萃分析, 局部应用免疫抑制药物环孢素结合自体结膜移植术为减少翼状胬肉复发最为成功的方法。其他辅助性治疗, 如丝裂霉素C (MMC) 、5-氟尿嘧啶 (5-FU) 和β-射线也在使用, 尽管使用这些疗法可引起许多不良反应。最近的研究表明, MDM2与p53之间的相互作用可能在治疗翼状胬肉的发病中起一定作用。与翼状胬肉样本的MMC实验室分析相比, Nutlin和MDM2拮抗剂对结膜细胞的毒性明显低于MMC。.