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采用丝裂霉素C辅助的上皮下光疗性角膜切削术/准分子原位角膜磨镶术治疗复杂准分子原位角膜磨镶术瓣。

Transepithelial phototherapeutic keratectomy/photorefractive keratectomy with adjunctive mitomycin-C for complicated LASIK flaps.

作者信息

Muller Laura T, Candal Eugenio M, Epstein Randy J, Dennis Richard F, Majmudar Parag A

机构信息

Cornea Service, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois, USA.

出版信息

J Cataract Refract Surg. 2005 Feb;31(2):291-6. doi: 10.1016/j.jcrs.2004.04.044.

DOI:10.1016/j.jcrs.2004.04.044
PMID:15767148
Abstract

PURPOSE

To evaluate the efficacy of transepithelial phototherapeutic keratectomy/photorefractive keratectomy (PTK/PRK) with prophylactic mitomycin-C for the treatment of refractive errors and maintenance of corneal clarity following flap complications in laser in situ keratomileusis (LASIK).

SETTING

Outpatient tertiary care center, Chicago, Illinois, USA.

METHODS

Ten eyes of 10 patients with LASIK flap complications had transepithelial PTK/PRK for correction of ametropia. Mitomycin-C 0.02% was applied to the stroma for 2 minutes following laser ablation. Postoperative uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), refractions, and slitlamp examinations were obtained.

RESULTS

Preoperatively, the mean UCVA was 20/400 (range 20/40 to counting fingers), the mean BSCVA was 20/28.5, and the spherical equivalent refractive errors ranged from +4.00 to -10.75 diopters (D). After the procedure, the mean UCVA was 20/28, the mean BSCVA was 20/21, and the spherical equivalent refractive errors ranged from +0.37 to -1.00 D. The mean follow-up ranged from 8 to 28 months. No patient experienced delayed reepithelialization, haze, or other signs of toxicity.

CONCLUSION

Mitomycin-C can be a useful adjunctive therapy for the prevention of haze when applying surface excimer laser therapy to a cornea following LASIK flap complications.

摘要

目的

评估采用预防性丝裂霉素-C的经上皮光治疗性角膜切削术/准分子激光屈光性角膜切削术(PTK/PRK)治疗激光原位角膜磨镶术(LASIK)瓣并发症后屈光不正及维持角膜清晰度的疗效。

设置

美国伊利诺伊州芝加哥市的三级门诊护理中心。

方法

10例LASIK瓣并发症患者的10只眼接受经上皮PTK/PRK以矫正屈光不正。激光消融后,将0.02%的丝裂霉素-C应用于基质2分钟。记录术后裸眼视力(UCVA)、最佳矫正视力(BSCVA)、验光结果及裂隙灯检查结果。

结果

术前,平均UCVA为20/400(范围为20/40至数指),平均BSCVA为20/28.5,等效球镜屈光不正范围为+4.00至-10.75屈光度(D)。术后,平均UCVA为20/28,平均BSCVA为20/21,等效球镜屈光不正范围为+0.37至-1.00 D。平均随访时间为8至28个月。无患者出现上皮化延迟、 haze或其他毒性迹象。

结论

在LASIK瓣并发症后对角膜应用表面准分子激光治疗时,丝裂霉素-C可作为预防haze的有效辅助治疗方法。

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