不同浓度丝裂霉素C在准分子激光上皮下角膜磨镶术中的应用

目的观察准分子激光上皮下角膜磨镶术(LASEK)中应用不同浓度丝裂霉素C(MMC)预防角膜上皮下混浊的有效性和毒性作用。方法167例患者根据手术中应用MMC的浓度不同分为4组:200 mg.L-1MMC组40例,0.2 mg.L-1MMC组46例,0.02 mg.L-1MMC组39例,术中应用不同浓度MMC浸泡角膜基质床2 m in;对照组42例,术中不应用MMC。观察术后2周、1月、3月和6个月时各组上皮愈合时间、角膜内皮细胞计数、角膜上皮下混浊、屈光状态和裸眼视力。结果术后各组上皮愈合及角膜内皮细胞计数无差别(P>0.05)。200 mg.L-1MMC组和0.2 mg.L-1MMC组术后角膜上皮下混浊、屈光度近视化改变及裸眼视力之间无统计学差别(P>0.05),与0.02 mg.L-1MMC组和对照组相比,200 mg.L-1MMC组和0.2 mg.L-1MMC组术后上皮下混浊明显减少,屈光度近视化改变轻,裸眼视力高(P<0.05)。结论MMC有预防LASEK手术后角膜上皮下混浊增生的作用,最低有效浓度为0.2 mg.L-1。

Application of different density mitomycin C in laser epithelial keratomileusis

Objective To investigate the effectivity and toxicity of mitomycin C （MMC） in preventing from haze of corneal epithelium after laser epithelial keratomileusis （LASEK）. Methods 167 cases were divided into 4 groups basing on the different density MMC in operation,including 200 mg·L^-1 MMC group （40 cases）,0.2 mg·L^-1 MMC group（46 cases）, 0.02 mg·L^-1 MMC group（39 cases） and control group（42 cases）.200 mg·L^-1 MMC group,0.2 mg·L^-1 MMC group,0.02 mg·L^-1 MMC group doused corneal stroma with different density MMC for 2 min in operation. The control group didn＇t use MMC in operation, The convalescent time of corneal epithelium, number of corneal endothelium cell, haze of corneal epithelium, refraction and naked vision were observed in the second week, the first, third and sixth month after operation. Results The convalescent time of corneal epithelium and the number of corneal endothelium cell had no statistic difference in every group after operation （P 〉 0.05 ）. There was no statistic difference in the haze, the myopia changes and the naked vision between 200 mg·L^-1 MMC group and 0.2 mg·L^-1 MMC group（P 〉0.05）. Compared with 0.02 mg·L^-1 MMC group and control group,the incidence of corneal haze was decreased, myopia change was slighter and the naked vision was higher（P 〈 0.05）. Conclusion MMC can reduce corneal haze and hyperplasia after LASEK, and minimal effective concentration was 0.02 mg·L^-1.