Chang Shu-Wen
Department of Ophthalmology, Far Eastern Memorial Hospital, Ban-Chiao, Taiwan.
J Refract Surg. 2005 Sep-Oct;21(5):446-53. doi: 10.3928/1081-597X-20050901-05.
To determine the soaking duration and concentration effect of mitomycin C (MMC) on the corneal keratocyte following single intraoperative application.
Two hundred ten pigmented rabbit eyes underwent mechanical epithelium debridement of the central 10-mm comea followed by soaking of six different solutions: MMC1A: 0.01% MMC x 1 minute; MMC1B: 0.01% MMC x 2 minutes; MMC2A: 0.02% MMC x 1 minute; MMC2B: 0.02% MMC x 2 minutes; BSS1: balanced salt solution (BSS) x 1 minute; and BSS2: BSS x 2 minutes. Thirty-five eyes were allocated into each group. Changes of the central comeal thickness, corneal clarity score, and keratocyte apoptosis were examined on days 0, 1, 2, 3, 5, 7, and 14.
A significant increase of central corneal thickness and corneal clarity score was noted in all MMC treated groups. The central corneal thickness recovered to its baseline level whereas the corneal clarity score remained increased at 2 weeks. The changes were more significant in MMC2 than in MMC1 corneas. However, changes of central corneal thickness and corneal clarity score were more significant in MMC1B than in MMC1A, whereas no difference was noted between MMC2A and MMC2B. Significantly higher stromal keratocyte loss and keratocyte apoptosis, from superficial to deep corneal stroma, was noted in MMC1 and MMC2 groups up to 14 days postoperatively, in a soaking duration and dose-dependent manner.
Single application of MMC on the corneal surface caused soaking concentration and duration dependent corneal edema and keratocyte apoptosis in this rabbit model.
确定术中单次应用丝裂霉素C(MMC)对角膜基质细胞的浸泡持续时间和浓度效应。
210只色素兔眼接受中央10mm角膜的机械上皮清创,随后浸泡六种不同溶液:MMC1A:0.01%MMC×1分钟;MMC1B:0.01%MMC×2分钟;MMC2A:0.02%MMC×1分钟;MMC2B:0.02%MMC×2分钟;BSS1:平衡盐溶液(BSS)×1分钟;BSS2:BSS×2分钟。每组分配35只眼。在第0、1、2、3、5、7和14天检查中央角膜厚度、角膜清晰度评分和基质细胞凋亡的变化。
所有MMC治疗组的中央角膜厚度和角膜清晰度评分均显著增加。中央角膜厚度恢复到基线水平,而角膜清晰度评分在2周时仍保持升高。MMC2组的变化比MMC1组更显著。然而,MMC1B组的中央角膜厚度和角膜清晰度评分变化比MMC1A组更显著,而MMC2A组和MMC2B组之间未观察到差异。在术后14天内,MMC1组和MMC2组从角膜浅基质到深基质均出现显著更高的基质细胞丢失和基质细胞凋亡,呈浸泡持续时间和剂量依赖性。
在该兔模型中,角膜表面单次应用MMC导致浸泡浓度和持续时间依赖性的角膜水肿和基质细胞凋亡。