Morales Alberto J, Zadok David, Mora-Retana Rolando, Martínez-Gama Eduardo, Robledo Nora E, Chayet Arturo S
Codet-Aris Vision Institute, Tijuana, Mexico.
Am J Ophthalmol. 2006 Sep;142(3):400-4. doi: 10.1016/j.ajo.2006.04.029.
To determine whether there is an increased risk to the corneal endothelium when mitomycin C (MMC) is administered after photorefractive keratectomy (PRK).
Prospective, randomized, double-blind, placebo-controlled crossover trial.
Corneal endothelium was analyzed preoperatively and postoperatively in 18 eyes of nine patients who were administered either MMC- or balanced salt solution (BSS)-supplemented PRK at Codet Aris Vision, Tijuana, Mexico. After laser ablation, one eye was randomly assigned to intraoperative topical MMC 0.02% treatment for 30 seconds, and the fellow eye (the control eye) was treated in a standard fashion with topical BSS. Preoperative pachymetry and endothelial cell count were performed and compared with postoperative measurements after one month and three months. Main outcome measure studied was endothelial cell loss.
There was no significant difference in the preoperative endothelial cell count between the 2 groups: MMC group 2835 +/- 395, control group 2779 +/- 492, P = .62. In the control group, at one month and three months the difference in the endothelial cell count was not statistically significant (P = .27, P = .14, respectively). However, in the MMC group the endothelial cell loss was statistically significant: at one month 14.7 +/- 5.1%, and at three months 18.2 +/- 9.0% (P = .0006, P = .002, respectively).
The use of intraoperative topical MMC 0.02% for 30 seconds after PRK may affect the endothelial cell count.
确定在准分子激光原位角膜磨镶术（PRK）后使用丝裂霉素C（MMC）是否会增加角膜内皮的风险。
前瞻性、随机、双盲、安慰剂对照交叉试验。
在墨西哥蒂华纳市阿利斯视力中心，对9例患者的18只眼进行了术前和术后角膜内皮分析，这些患者接受了补充MMC或平衡盐溶液（BSS）的PRK治疗。激光消融后，一只眼随机分配接受术中局部应用0.02%MMC治疗30秒，另一只眼（对照眼）以标准方式局部应用BSS治疗。进行术前角膜厚度测量和内皮细胞计数，并与术后1个月和3个月的测量结果进行比较。研究的主要结局指标是内皮细胞损失。
两组术前内皮细胞计数无显著差异：MMC组为2835±395，对照组为2779±492，P = 0.62。在对照组中，1个月和3个月时内皮细胞计数的差异无统计学意义（分别为P = 0.27，P = 0.14）。然而，在MMC组中，内皮细胞损失具有统计学意义：1个月时为14.7±5.1%，3个月时为18.2±9.0%（分别为P = 0.0006，P = 0.002）。
PRK后术中局部应用0.02%MMC 30秒可能会影响内皮细胞计数。
