目的:探讨术中使用0.2g/L丝裂霉素C(mytomycinC,MMC)对LASEK手术后效果的影响。方法:LASEK患者249例489眼随机分成两组,0.2g/L丝裂霉素C组128例251眼,9g/L氯化钠溶液(NaClsolution,NS)组121例238眼,于LASEK手术完毕后滴于切削区,根据屈光度≤-3.00D,-3.25～-6.00D,-6.25～-9.00D,≥-9.25D分别置留30,60,90,110s,术后随访两组患者haze发生率、视力、屈光度变化、角膜内皮细胞密度、上皮愈合时间以及其他并发症。结果:随访1a,haze的发生率,MMC组为13.2%,NS组为31.1%;MMC组2.0%影响视力;NS组5.9%影响视力。等值球镜变化:术后1,6mo及1a的情况,MMC组分别为:-0.67±0.11D,-0.58±0.21D,-0.54±0.18D;NS组分别为:-0.87±0.14D,-1.30±0.26D,-1.05±0.20D。术前及术后1,6mo及1a角膜内皮镜检查角膜内皮细胞密度情况,MMC组分别为:3005.92±382.54,2996.69±374.19,2988.37±367.33,3000.05±299.84;NS组分别为:2991.99±323.18,2970.11±317.79,3080.21±317.20,2998.97±339.62。两组各指标的比较,除角膜内皮细胞密度情况外,差异有统计学意义(P<0.05)。MMC组取镜后出现2例2眼丝状角膜炎。结论:术中使用0.2g/L丝裂霉素C可以减少LASEK术后并发症,使用较为方便,并且安全有效。

AIM:To investigate the operation effects of using 0.2g/L mytomycin C (MMC) on laser epithelium keratectomileusis (LASEK).METHODS:Two hundred and forty-nine patients (489 eyes) were devided into two groups:group MMC 128 patients 251 eyes;group 9g/L NaCl solution(NS) 121 with patients 238 eyes.0.2g/L MMC solution and 9g/L NS were intraoperatively applied to the cases respectively.The two kinds of instilled solutions were held up in the eyes for 30,60,90 and 110 seconds respectively according to the diopter ≤-3.00D,-3.25--6.00D,-6.25--9.00D,≥-9.25D.Observe indicate including the formation of corneal haze,the situation of visual acuity,the change of diopter,corneal endothelium density,the healing of cornea and so on.RESULTS:All the patients were followed up for 1 year.The clinical data of group MMC and group NS were respectively as follows:the occurrence rate of haze was 13.2% and 31.1%;the appearance rate of influenced visual acuity was 2.0% and 5.9%;the changes of diopter after 1 month,6 months and 1 year,MMC group was-0.67±0.11D,-0.58±0.21D,-0.54±0.18D;NS group was-0.87±0.14D,-1.30±0.26D,-1.05±0.20D;the corneal endothelium density of the two groups preoperation,1 month,6 months and 1 year after operation respectively was 3005.92±382.54 and 2991.99±323.18,2996.69±374.19 and 2970.11±317.79,2988.37±367.33 and 3080.21± 317.20,3000.05±299.84 and 2998.97±339.62.There was statistically significant difference (P<0.05)in those index.But there were two cases 2 eyes of filamentary keratitis after taking off lense in group MMC.CONCLUSION:Using MMC 0.2g/L solution intraoperatively can effectively inhibit haze formation and therefore improve the results of LASEK greatly.

R779.63

中国河北省教育厅科研资助项目(No.2008482)~~