Porges Yair, Ben-Haim Oded, Hirsh Ami, Levinger Samuel
Division of Ophthalmology, Sanz Medical Center, Laniado Hospital, Netanya, Israel.
J Refract Surg. 2003 Jan-Feb;19(1):40-3. doi: 10.3928/1081-597X-20030101-08.
To evaluate the safety and efficacy of phototherapeutic keratectomy (PTK) with single application of mitomycin C for patients with severe corneal haze following photorefractive keratectomy (PRK) for high myopia.
Eight eyes of seven patients were treated with PTK and intraoperative topical application of mitomycin C (0.02%) for severe corneal haze (grade 3) following PRK for myopia.
All patients' visual performance improved significantly. Mean preoperative visual acuity (20/200 for both UCVA and BSCVA) improved significantly to 20/33 (0.6) and 20/30 (0.7) for UCVA and BSCVA, respectively. Six eyes (85.7%) had improved UCVA to 20/40 or better and gained five or more lines of UCVA. The corneal haze score decreased from grade 3 initially (for all eyes prior to PTK and mitomycin C) to a final mean haze score of 0.3 (range 0 to 0.5). Mean final spherical equivalent refraction achieved was -1.30 +/- 1.60 D (range -3.75 to +1.25 D). One eye gained only three lines of visual acuity due to regression and residual haze. No adverse effects related to the use of mitomycin C were recorded.
PTK with a single intraoperative application of mitomycin C was safe and effective in reducing corneal haze and improving visual acuity in patients with severe corneal haze following PRK.
评估对于高度近视患者行准分子激光原位角膜磨镶术(PRK)后出现严重角膜混浊的患者,单次应用丝裂霉素C的光治疗性角膜切削术(PTK)的安全性和有效性。
7例患者的8只眼接受了PTK治疗,并在术中局部应用丝裂霉素C(0.02%)以治疗PRK治疗近视后出现的严重角膜混浊(3级)。
所有患者的视力均显著改善。术前平均视力(裸眼视力和最佳矫正视力均为20/200)显著提高,裸眼视力和最佳矫正视力分别提高到20/33(0.6)和20/30(0.7)。6只眼(85.7%)的裸眼视力提高到20/40或更好,且裸眼视力提高了5行或更多。角膜混浊评分从最初的3级(所有眼在PTK和丝裂霉素C治疗前)降至最终平均混浊评分为0.3(范围0至0.5)。最终平均等效球镜度为-1.30±1.60 D(范围-3.75至+1.25 D)。1只眼因回退和残留混浊仅提高了3行视力。未记录到与丝裂霉素C使用相关的不良反应。
对于PRK后出现严重角膜混浊的患者,术中单次应用丝裂霉素C的PTK在减轻角膜混浊和提高视力方面是安全有效的。