丝裂霉素对PRK术后角膜上皮下雾状混浊的影响

目的:探讨丝裂霉素(mitomycin C,MMC)对准分子激光角膜切削术(photorefractive keratectomy,PRK)后角膜上皮下雾状混浊(haze)的影响。方法:随即对122例244眼患者进行PRK手术,等值球镜约在-4.00～-9.00D。其中A组(MMC组)61例122眼PRK术中将浸有0.2g/L丝裂霉素棉签,浸润角膜中央切削区,持续时间约25～30s后,用10～20mL平衡盐水液冲洗;B组(BBS组)61例122眼,作为对照组,PRK术后仅用平衡盐水冲洗。两组患者术后均配戴同一型号博士伦隐形眼镜,用同一组PRK术后常规眼药滴眼,并于术后1wk;0.5,1,3,6,8mo;1a,由同一技术人员在裂隙灯下观察角膜情况及haze评分。结果:不同时间MMC组和BBS组角膜上皮愈合时间相比差异无显著意义;术后观察3～18mo,A组haze明显轻于B组,差异具有统计学意义(P=0.014),且无明显毒副作用及其它并发症发生。结论:PRK术后haze的形成与多种因素有关,但PRK术后应用浸有MMC的棉签浸润切削区可有效的抑制haze的形成。

Effect of mitomycin C on haze formation after photorefractive keratectomy

AIM:To explore the effect of mitomycin C on haze formation after photorefractive keratectomy(PRK).METHODS: One hundred and twenty-two patients (244 eyes) after PRK were included. Mean spherical equality were -4.00--9.00D. Group A (61 patients) were treated with intraoperative application of MMC (0.2g/L) for 25-30 seconds, then were flushed out with 10-20mL BBS. Group B (61 patients) were treated with BBS after PRK. All patients wore cornea contact lens after surgery and accepted the same regular medicine. The same doctor observe the cornea and haze 1 week, 0.5 month, 1 month, 3 months, 6 months after surgery . RESULTS: The time of corneal epithelium recovery was not statistic ally significant. The rate of haze of MMC group were less than the control group after surgery (P=0.014). No toxic effect and complications of MMC were found after surgery.CONCLUSION: The formation of haze had relation with many kinds of varied factors. Application of mitomycin C after PRK was effective to prevent from haze.