丝裂霉素C防止LASEK术后角膜雾状混浊的临床研究

目的探讨准分子激光上皮瓣下角膜磨镶术（LASEK）术中应用丝裂霉素C（MMC）抑制术后角膜上皮下雾状混浊（Haze）的疗效。方法108例216眼行LASEK术的近视患者随机分为两组：MMC组56例112眼及对照组52例104眼。MMC组在激光切削完毕后用浸有0．02％MMC的棉片覆于角膜切削区1-1．5min；对照组采用常规LASEK手术。术后早期观察眼部刺激症状及角膜上皮愈合情况；1、3、6、12个月复查视力、屈光度、角膜Haze及角膜地形图。结果两组上皮愈合时间差异无统计学意义（P＞0，05）；术后1、3、12个月，MMC组Haze发生率明显低于对照组（P＜0．01），未出现2级及2级以上的Haze；术后1年两组达最佳矫正视力者差异无统计学意义（P＞0.05）。但MMC组中高于及低于最佳矫正视力1行的眼数与对照组相比，差异有统计学意义（P＜0．05）；MMC组术后1个月与1年的角膜曲率差异无统计学意义，而对照组差异有统计学意义（P＜0．05）。结论LASEK术中应用低浓度MMC能有效抑制LASEK术后角膜Haze的产生，防止屈光状态回退，有助于视力的提高。

A Clinical Study of MMC for Prevention Against Haze after LASEK

Objective To explore the clinical effect of application of the MMC for prevention against Haze after LASEK.Methods 216 eyes of 108 cases with myopia underwent LASEK were divided into two groups,MMC group and control group.MMC group was covered by 0.02% MMC cotton pad on the corneal stroma for 1-1.5minutes after excimer laser ablation.Control group was performed conventional LASEK. Stimulus syndrome and corneal epithelial healing time were observed at the early stage after operation.Visual vision,diopter,Haze and corneal topograph were examined in 1,3,6,12 months after operation.Results (1)Time for healing of the corneal epithelium in the two groups was not significantly different(P>0.05).(2)Haze in the MMC group was significantly lower than that in the control group(P<0.05) in 1,3,6,12months after operation.Haze at a grade higher than 2 also was not found in MMC group.(3)BSCUA in the two groups was not significantly different after one year operation(P>0.05).But the eyes which vision was above and low one row of BSCUA were significantly different between two groups(P<0.05).(4)No significant difference of corneal refraction was found between one month and one year after operation by paired T-test(P>0.05).However,corneal refraction in the control group was significantly different at the same time as the MMC group(P<0.05).Conclusion The introperative application of the lower concentration MMC in LASEK can effectively refrain the occurrence of Haze,prevent the recession of the refractive condition,and enhance the vision after LASEK.