国际眼科杂志
國際眼科雜誌
국제안과잡지
INTERNATIONAL JOURNAL OF OPHTHALMOLOGY
2014年
1期
52-55
,共4页
刘兵%张湘%茹海霞%张梅%杨春燕
劉兵%張湘%茹海霞%張梅%楊春燕
류병%장상%여해하%장매%양춘연
角膜切削术%激光%丝裂霉素C%近视%角膜糜烂%角膜上皮下雾状混浊
角膜切削術%激光%絲裂黴素C%近視%角膜糜爛%角膜上皮下霧狀混濁
각막절삭술%격광%사렬매소C%근시%각막미란%각막상피하무상혼탁
keratectomy%laser%mitomycin C%myopia%corneal erosion%haze
目的：观察丝裂霉素C（mitomycin C， MMC）辅助准分子激光角膜切削术（ PRK）的疗效及并发症分析。<br> 方法：回顾性临床病例研究。随机选择2009年40例80眼实施PRK治疗近视的患者作为常规组，2010年PRK术中应用0．2 g/L MMC 20 s的40例80眼作为MMC组。术后7d；1，3，6，12mo观察裸眼视力、屈光状态以及角膜上皮愈合、发生糜烂、角膜干燥和haze情况，两组数据进行对比分析。<br> 结果：术后12 mo随访期间，两组裸眼视力、术后等效球镜、角膜上皮愈合及干眼情况差异无统计学意义。常规组有2眼，MMC组有9眼发生角膜糜烂伴丝状角膜炎，两组差异有统计学意义（Pearson χ2＝4．783，P＜0．05）。全部病例均治愈，没有复发病例。常规组、MMC 组术后1，3，6，12 mo haze 的发生率分别为26％，6％，2％，0和44％，25％，10％，2％，术后1mo（Pearson χ2＝5．385，P＜0．05）、3mo（Pearson χ2＝10．667，P＝0．001）差异有统计学意义。结论：PRK术中使用0．2 g/L MMC可以减少术后haze的发生。 MMC对PRK术中保留的角膜上皮的影响可能是术后角膜糜烂发生的原因之一，术中要避免接触到治疗区外保留的正常角膜上皮。
目的：觀察絲裂黴素C（mitomycin C， MMC）輔助準分子激光角膜切削術（ PRK）的療效及併髮癥分析。<br> 方法：迴顧性臨床病例研究。隨機選擇2009年40例80眼實施PRK治療近視的患者作為常規組，2010年PRK術中應用0．2 g/L MMC 20 s的40例80眼作為MMC組。術後7d；1，3，6，12mo觀察裸眼視力、屈光狀態以及角膜上皮愈閤、髮生糜爛、角膜榦燥和haze情況，兩組數據進行對比分析。<br> 結果：術後12 mo隨訪期間，兩組裸眼視力、術後等效毬鏡、角膜上皮愈閤及榦眼情況差異無統計學意義。常規組有2眼，MMC組有9眼髮生角膜糜爛伴絲狀角膜炎，兩組差異有統計學意義（Pearson χ2＝4．783，P＜0．05）。全部病例均治愈，沒有複髮病例。常規組、MMC 組術後1，3，6，12 mo haze 的髮生率分彆為26％，6％，2％，0和44％，25％，10％，2％，術後1mo（Pearson χ2＝5．385，P＜0．05）、3mo（Pearson χ2＝10．667，P＝0．001）差異有統計學意義。結論：PRK術中使用0．2 g/L MMC可以減少術後haze的髮生。 MMC對PRK術中保留的角膜上皮的影響可能是術後角膜糜爛髮生的原因之一，術中要避免接觸到治療區外保留的正常角膜上皮。
목적：관찰사렬매소C（mitomycin C， MMC）보조준분자격광각막절삭술（ PRK）적료효급병발증분석。<br> 방법：회고성림상병례연구。수궤선택2009년40례80안실시PRK치료근시적환자작위상규조，2010년PRK술중응용0．2 g/L MMC 20 s적40례80안작위MMC조。술후7d；1，3，6，12mo관찰라안시력、굴광상태이급각막상피유합、발생미란、각막간조화haze정황，량조수거진행대비분석。<br> 결과：술후12 mo수방기간，량조라안시력、술후등효구경、각막상피유합급간안정황차이무통계학의의。상규조유2안，MMC조유9안발생각막미란반사상각막염，량조차이유통계학의의（Pearson χ2＝4．783，P＜0．05）。전부병례균치유，몰유복발병례。상규조、MMC 조술후1，3，6，12 mo haze 적발생솔분별위26％，6％，2％，0화44％，25％，10％，2％，술후1mo（Pearson χ2＝5．385，P＜0．05）、3mo（Pearson χ2＝10．667，P＝0．001）차이유통계학의의。결론：PRK술중사용0．2 g/L MMC가이감소술후haze적발생。 MMC대PRK술중보류적각막상피적영향가능시술후각막미란발생적원인지일，술중요피면접촉도치료구외보류적정상각막상피。
AIM: To observe clinical effects and complications analysis of adjunctive mitomycin C ( MMC ) on photorefractive keratectomy( PRK) for myopia. <br> METHODS: In this retrospective study, 80 eyes of 40 patients were treated by PRK in 2009 as control group with the LaserSight SLX excimer laser. Eighty eyes of 40 patients were treated with 0.2g/L MMC 20s during PRK in 2010 as MMC group.Uncorrected visual acuity (UCVA), refraction, corneal epithelial healing, erosions, dry eyes, and haze were examined at 1 month, 3, 6 and 12 months postoperatively, and the 2 groups were compared and analyzed. <br> RESULTS: The differences between control and MMC group were not statistically significant in preoperative mean ages, UCVAs, best spectacle -corrected visual acuities, corneal depths, spherical equivalents ( SEs ) , and laser ablation zones, depths, and times.During one year follow-up, the differences were also not in UCVAs, SEs, corneal epithelial healing, and dry eyes.But corneal erosions with filament keratitis were observed in 9 eyes in MMC group and 2 in control group, the difference was statistically significant (Pearson χ2=4.783, P=0.029).All the eyes were cured, and no recurrence occurred.The haze frequencies were 26%, 6%, 2%, 0 in MMC group at the 1 month, 3, 6, 12 months, and 44%, 25%, 10%, 2%in control group, respectively.The frequency differences were statistically significant at the 1 month(Pearson χ2=5. 385, P=0.02) and 3(Pearsonχ2=10.667, P=0.001) months after surgery between the 2 groups. <br> CONCLUSION:Intraoperative MMC can reduce the haze frequency and grade after PRK for myopia.The effect of MMC on preserved corneal epithelium may be one of the reasons to happen corneal erosions after PRK. It is important to avoid 0.2g/L MMC exposure to corneal epithelium outside treatment zone.
