中高度近视患者LASEK术中运用丝裂霉素C预防Haze的临床研究

目的研究准分子激光上皮瓣下角膜磨镶术（laserepithelial keratomileusis,LASEK）术中使用体积分数0.02%丝裂霉素C（mitomycin C,MMC）预防Haze反应措施的可行性与安全性。方法随机选取进行LASEK手术的近视患者100例,以右眼为实验组,左眼为对照组。对照组进行常规LASEK手术,实验组在激光角膜切削完毕后立即将浸透了体积分数0.02%MMC溶液的6mm直径滤纸片覆盖在角膜基质床上,持续12s,充分冲洗角膜,复位角膜上皮,配戴-1.0D角膜接触镜。随访观察12个月。结果术后12个月内,对照组出现0.5～1级Haze15例,2级以上Haze4例;实验组出现0.5～1级Haze5例,未出现2级以上Haze;差异有统计学意义（P〈0.05）。实验组角膜上皮的愈复时间、疼痛反应与对照组相比差异无统计学意义。结论LASEK术中使用体积分数0.02%MMC处理角膜切削面,可以有效预防LASEK术后Haze增生,提高LASEK术后的远期效果,使用简单安全。

Clinical study of applying mitomycin C in LASEK surgery of middle or high myopia to prevent Haze happening

Objective To study the feasibility and security of applying mitomycin C(MMC) in laser epithelial keratomileusis(LASEK) surgery of middle or high myopia to prevent the formation of Haze under corneal epithelium.Methods Hundred patients for LASEK surgery were selected randomly,the right eyes were set as test group,and the left eyes as control group.The control group went for general LASEK,while for the test group,a filter paper of 6 mm diameter saturated with 0.02%MMC solution was covered on the corneal stroma bed after the laser ablation,about 12 seconds later,the cornea was washed fully,and the corneal epithelium was replaced,-1.0 D contact lens was prescribed,and the follow-up time was 12 months.Results Within the 12 months,15 cases suffered 0.5~1 level Haze and 4 cases with 2 level or more than Haze in control group,while 0.5~1 level Haze appeared in tested group with no 2 level or more than Haze case,there was significant difference(P<0.05).But there was no difference in healing time and pain reaction of corneal epithelium between two groups.Conclusion With 0.02% MMC in LASEK,Haze phenomenon can be prevented effectively,and the distant effect will also be promoted.This method is proved to be safe and simple,but its side effect and long curative effect need to be observed further more.