PRK+MMC与LASEK治疗高度近视效果比较

目的比较PRK术中预防性使用丝裂霉素C（MMC）治疗高度近视和LASEK治疗高度近视的疗效.方法将高度近视（-6.0～-10.0D）随机分为PRK＋MMC组40例（80眼）和LASEK组38例（76眼）.另以早年PRK手术屈光状态与之相似的40例（80眼）作为对照.PRK＋MMC组在PRK术中使用0.02%MMC,LASEK组采用常规LASEK,评价术后角膜上皮下雾状浑浊（haze）,屈光回退、视力及角膜内皮细胞改变等情况.结果PRK＋MMC组未出现2级或2级以上haze,无术后矫正视力下降者,术后欠矫小于-0.5D者70眼;LASEK组有6眼出现2级及2级以上haze,有6眼出现术后矫正视力下降,术后欠矫小于-0.5D者56眼.两组的差异有显著性.使用MMC未见明显毒副作用.结论PRK术中预防性使用MMC,在术后减少haze、防止屈光回退、改善视力方面较LASEK为优.

Curative effect comparison between PRK with the prophylactic use of mitomycin-C and LASEK for high myopia

Objective To compare the curative effect of the PRK procedure with prophylactic use of mitomycin_C and LASEK procedure for high myopia.Methods 78 cases of myopia with a spherical equivalent correction between-6.00 and-10.00 diopters(D) were divided into 2 groups randomly: first group(PRK+MMC group) and second group(LASEK group).The first group contained 40 patients(80 eyes) were treated by PRK with a intraoperative use of mitomycin(0.2 mg/mL),which was applied topically with a soaked microsponge placed over the ablated area and maintained for 2 minutes.The second group contained 38 patients(76 eyes) were treated by laser-assisted subepithelial keratectomy(LASEK) procedure.Refraction,uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA),corneal endothelial cell counts, and slitlamp evidence of corneal opacity(haze) or other visible complications were evaluated.Results No toxic or side effects were encountered postoperatively.ln first group,no eye had a haze rate higher than stage 1 during the first year follow_up;6 eyes(7.9%)in the second group had haze severe than stage 1(P<0.05).At I Year,refractive outcome was statistically significant,70 eyes(87.5%) in first group and 56 eyes(73.6%) in second group within0.50 D.Conclusion The prophylactic use of 0.02% mitomycin_C solution intraoperatively in PRK can produce lower haze rates,better UCVA and BCVA results,and more accurate refractive outcomes.