细胞色素c过氧化物酶对屈光性角膜切削术后角膜上皮愈合过程的影响。

Scalinci Sergio Zaccharia, Scorolli Lucia, De Martino Liberatina, Corazza Daniele, Morara Mariachiara, Meduri Renato Alberto

Department of Pathophysiological Optics, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.

J Cataract Refract Surg. 2005 Oct;31(10):1928-31. doi: 10.1016/j.jcrs.2005.03.076.

PURPOSE

To evaluate the role of commercially prepared cytochrome c peroxidase eyedrops in corneal epithelial healing after photorefractive keratectomy (PRK).

SETTING

Department of Pathophysiological Optics, Faculty of Medicine, University of Bologna, Bologna, Italy.

METHODS

Seventy-two eyes of 36 patients affected by low to moderate refractive error (myopia and myopic astigmatism) had uneventful bilateral photorefractive keratectomy (PRK). In each patient, 1 eye (32 eyes) received standard postoperative therapy plus cytochrome c peroxidase eyedrops (3 times a day for 1 week or until corneal reepithelialization was completed, corresponding to 15 000). The fellow eye served as the control and received standard postoperative therapy plus placebo. Patients were monitored daily starting the day after surgery for 7 days to evaluate the corneal reepithelialization rate using a video slitlamp camera with a cobalt blue light. Mean diameter of corneal wounds was measured. Videotaped images were recorded and analyzed by computer planimetry.

RESULTS

All the eyes treated with cytochrome c peroxidase eyedrops healed completely before day 5 postsurgery, with a mean reepithelialization time of 91 hours +/- 14 (SD); the mean reepithelialization time was 154 +/- 9 in eyes receiving placebo (P<.05); the mean reepithelialization rate was 0.066 +/- 0.007 mm/hour in the cytochrome c peroxidase group and 0.039 +/- 0.006 mm/hour in the control group (P<.05). There were no statistically significant differences between groups in corneal haze presentation during follow-up (P =.70), perhaps because the time period was too brief (7 days). However, corneal clarity, on slitlamp biomicroscopy in the study group was greater than in the control group. No side effects or toxic effects were documented.

CONCLUSIONS

These data suggest that cytochrome c peroxidase significantly accelerates epithelial healing after PRK. Further clinical study should be performed to prove the results obtained in this pilot study and the long-term efficacy of cytochrome c peroxidase to prevent corneal haze.

目的

评估市售细胞色素c过氧化物酶眼药水在准分子激光角膜切削术（PRK）后角膜上皮愈合中的作用。

地点

意大利博洛尼亚大学医学院病理生理光学系。

方法

36例患有低度至中度屈光不正（近视和近视散光）的患者的72只眼睛接受了双侧顺利的准分子激光角膜切削术（PRK）。在每位患者中，1只眼睛（32只眼）接受标准术后治疗加细胞色素c过氧化物酶眼药水（每天3次，持续1周或直至角膜重新上皮化完成，相当于15000）。对侧眼作为对照，接受标准术后治疗加安慰剂。术后次日起每天对患者进行监测，持续7天，使用带有钴蓝光的视频裂隙灯相机评估角膜重新上皮化率。测量角膜伤口的平均直径。通过计算机平面测量法记录并分析录像图像。

结果

所有接受细胞色素c过氧化物酶眼药水治疗的眼睛在术后第5天前完全愈合，平均重新上皮化时间为91小时±14（标准差）；接受安慰剂的眼睛平均重新上皮化时间为154±9（P<0.05）；细胞色素c过氧化物酶组的平均重新上皮化率为0.066±0.007毫米/小时，对照组为0.039±0.006毫米/小时（P<0.05）。随访期间两组在角膜混浊表现方面无统计学显著差异（P = 0.70），可能是因为时间段太短（7天）。然而，研究组裂隙灯生物显微镜检查显示的角膜清晰度高于对照组。未记录到副作用或毒性作用。