Chang Shu-Wen
Department of Ophthalmology, Far Eastern Memorial Hospital, 21 ZSection 2, Nan-Ya South Road, Ban-Chiao, Taipei 220, Taiwan.
J Cataract Refract Surg. 2004 Aug;30(8):1742-50. doi: 10.1016/j.jcrs.2003.12.044.
To determine the effect of mitomycin-C (MMC) on the cornea after a single intraoperative application.
Department of Ophthalmology, Far Eastern Memorial Hospital, Ban-Chiao, Taipei, Taiwan.
Mechanical epithelium debridement of the central 10.0 mm of the cornea was performed in 63 pigmented rabbits. One group of corneas (MMC1, n = 42) was soaked with MMC 0.01% solution for 2 minutes; the second group (MMC2, n = 42) was soaked with MMC 0.02% solution for 2 minutes. Control corneas (n = 42) were soaked with balanced salt solution for 2 minutes. Changes in the central corneal thickness, clarity, epithelial defect size, endothelial cell density, and endothelial apoptosis in the 3 groups were examined on days 0, 1, 2, 3, 5, 7, and 14.
There was a dose-dependent increase in corneal thickness, decrease in corneal clarity, and increase in endothelial apoptosis after a single intraoperative application of MMC. The endothelium was significantly swollen and became pleomorphic and polymegethic with a concomitant decrease in endothelial cell density, also in a dose-dependent manner.
A single application of MMC on the corneal surface caused dose-dependent corneal edema and endothelial apoptosis in the rabbit model. Further clinical study of human eyes is warranted.
确定术中单次应用丝裂霉素-C(MMC)对角膜的影响。
台湾台北板桥远东纪念医院眼科。
对63只有色家兔的角膜中央10.0mm进行机械上皮清创。一组角膜(MMC1,n = 42)用0.01%的MMC溶液浸泡2分钟;第二组(MMC2,n = 42)用0.02%的MMC溶液浸泡2分钟。对照角膜(n = 42)用平衡盐溶液浸泡2分钟。在第0、1、2、3、5、7和14天检查三组角膜的中央厚度、透明度、上皮缺损大小、内皮细胞密度和内皮细胞凋亡情况。
术中单次应用MMC后,角膜厚度呈剂量依赖性增加,角膜透明度降低,内皮细胞凋亡增加。内皮细胞明显肿胀,变得大小不一、形态各异,同时内皮细胞密度降低,也呈剂量依赖性。
在兔模型中,角膜表面单次应用MMC会导致剂量依赖性角膜水肿和内皮细胞凋亡。有必要对人眼进行进一步的临床研究。