丝裂霉素预防准分子激光屈光性角膜切削术后角膜混浊的临床研究

目的:探讨准分子激光屈光性角膜切削术中使用0.2g/L丝裂霉素(MMC)预防术后角膜上皮下混浊(haze)的安全性、有效性。方法:对120例(240眼)屈光不正的患者进行准分子激光屈光性角膜切削术,术中使用0.2g/L丝裂霉素,作用时间为20~90s,观察术后角膜上皮愈合时间、观察术后1,3,6,12mo时裸眼视力、矫正视力、屈光状态、haze形成情况及并发症、角膜内皮细胞计数等。结果:角膜上皮愈合时间为3.01±0.72d;手术前后角膜内皮细胞计数统计学上无显著性差异(P=0.62);术后1,3,6,12mo时裸眼视力、矫正视力、屈光状态统计学上无显著性差异;术后6mo0~0.5级haze218眼(90.8%),1级haze21眼(8.75%),2级haze1眼(0.83%),术后12mo1级haze12眼(5%);术后未见丝裂霉素毒性反应及并发症。结论:使用0.2g/L丝裂霉素预防准分子激光屈光性角膜切削术后角膜上皮下混浊安全、有效。

Clinical research on mitomyein C inhibiting haze formation after photorefractive kera-tectomy

AIM: To evaluate the efficacy and safety of intraope-rative application of mitomycin C (MMC) inhibiting haze in photorefractive keratectomy (PRK). ·METHODS: A total of 120 patients (240 eyes) undergoning PRK were treated with of MMC (0.02%) for 20-90 seconds. We regulary observed the recovery of cornea epithelial after surgery. Compared the uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refraction, haze, complications and endothelial cell counts 1, 3, 6 ,12 months after PRK. ·RESULTS: The time of corneal epithelium recovery were 3.01 ± 0.72days. Postoperative endothelial cell density did not show a significant difference from preoperative measurements(P=0.62). Difference of UCVA, BCVA, refraction and haze were not statistcally significant between 1, 3, 6, 12 months after PRK. Haze at grade Ⅰ and Ⅱ occurred in 21 eyes (8.75%) and 2 eyes(0.83%)6 months after PRK. Haze at grade Ⅰexisted in 12 eyes (5%). No toxic effect and complications of MMC were found after surgery. ·CONCLUSION: Photorefractive keratectomy (PRK) with intraoperative application of mitomycin C is a safe and effective treatment for preventing haze after surgery.