CAJ | 학술논문

目的探讨丝裂霉素C(MMC)在准分子激光上皮瓣下角膜磨镶术(LASEK)中应用对高度近视术后屈光度稳定性的影响.方法前瞻性对照研究.33例(66眼)实施LASEK手术治疗高度近视的患者,术中随机选择患者的一眼术中局部应用0.02％MMC(MMC组),另一眼行常规LASEK术(对照组).于手术后3、6、9、12、15周测量屈光度,非接触眼压计测量眼压,裂隙灯下观察角膜上皮下雾状混浊情况,两组间数据进行配对t检验分析.结果 MMC组术后3、6周分别与15周的屈光度相比较,差异有统计学意义(t=2.254、2.175,P＜0.05),9、12周与15周的屈光度比较,差异无统计学意义(P＞0.05)；对照组术后3、6、9周分别与15周的屈光度相比较,差异有统计学意义(t=3.315、2.440、2.356,P＜0.05)；12周与15周之间,屈光度值差异无统计学意义(P＞0.05).MMC组0.1％氟米龙眼液的使用时间为9周,平均使用频度为2.6次/d,明显低于对照组(12.9周,频度为2.9次/d).结论低浓度的MMC在高度近视LASEK术中的应用,能使得屈光状态在更短的时间内稳定,明显缩短了术后皮质类固醇滴眼液的使用时间.
목적 탐토사렬매소C(MMC)재준분자격광상피판하각막마양술(LASEK)중응용대고도근시술후굴광도은정성적영향.방법 전첨성대조연구.33례(66안)실시LASEK수술치료고도근시적환자,술중수궤선택환자적일안술중국부응용0.02％MMC(MMC조),령일안행상규LASEK술(대조조).우수술후3、6、9、12、15주측량굴광도,비접촉안압계측량안압,렬극등하관찰각막상피하무상혼탁정황,량조간수거진행배대t검험분석.결과 MMC조술후3、6주분별여15주적굴광도상비교,차이유통계학의의(t=2.254、2.175,P＜0.05),9、12주여15주적굴광도비교,차이무통계학의의(P＞0.05)；대조조술후3、6、9주분별여15주적굴광도상비교,차이유통계학의의(t=3.315、2.440、2.356,P＜0.05)；12주여15주지간,굴광도치차이무통계학의의(P＞0.05).MMC조0.1％불미용안액적사용시간위9주,평균사용빈도위2.6차/d,명현저우대조조(12.9주,빈도위2.9차/d).결론 저농도적MMC재고도근시LASEK술중적응용,능사득굴광상태재경단적시간내은정,명현축단료술후피질류고순적안액적사용시간.
Objective To evaluate the effect of intraoperative mitomycin C on the stability of refraction after laser-assisted subepithelial keratomileusis (LASEK) in treating high myopia.Methods In this prospective control study,66 eyes of 33 patients were divided into two groups.One eye of each patient was treated with 0.02％ mitomycin C (MMC) during LASEK for myopia (MMC group) while the other eye was not treated (control group).Corneal refraction,intraocular pressure using noncontact tonometry and haze were measured at 3,6,9,12 and 15 weeks after LASEK,and the two groups were compared using paired t test.Results The difference in refraction between the 3rd week and the 6th week in the MMC group was statistically significant (t=2.254,2.175,P＜0.05),while the differences between the other adjacent time points were not statistically significant.Refraction in the MMC treatment group became stable at 9 weeks after surgery.In the control group,the refractive differences between the 3rd and 6th weeks and the 6th and 9th weeks were statistically significant (t=3.315,2.440,2.356,P＜0.05),while the differences between the other times were not significant.Refraction in the control group became stable 12 weeks after surgery.The average course and frequency of using 0.1％ fluorometholone eye drops after surgery in the MMC group were 9 weeks and 2.6 times per day while course and frequency were 12.9 weeks and 2.9 times per day for the control group.Conclusion Intraoperative MMC can shorten the refractive fluctuation time after LASEK for treating high myopia.The effect may reduce the frequency and dosage of corticosteroid eye drops after surgery and avoid the occurrence of steroid-induced ocular hypertension and glaucoma.