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减少光折射性角膜切削术中预防性丝裂霉素 C 的应用时间。

Reduced application time for prophylactic mitomycin C in photorefractive keratectomy.

机构信息

Rush University Medical Center, Chicago, Illinois, USA.

出版信息

Ophthalmology. 2010 May;117(5):885-9. doi: 10.1016/j.ophtha.2009.10.024. Epub 2010 Feb 16.

Abstract

OBJECTIVE

To determine whether the duration of mitomycin C (MMC) 0.02% application affects visual outcome or the incidence of subepithelial haze in patients undergoing photorefractive keratectomy (PRK) with prophylactic administration of MMC.

DESIGN

Retrospective, comparative case series.

PARTICIPANTS

Two hundred sixty-nine eyes undergoing PRK.

METHODS

This was a retrospective comparative case series that included 269 eyes that underwent PRK with prophylactic MMC application for 120 seconds (group 1, n = 74), 60 seconds (group 2, n = 36), or 12 seconds (group 3, n = 159). The mean preoperative spherical equivalent was -6.49 diopters (D) in group 1, -6.77 D in group 2, and -7.10 D in group 3. Photorefractive keratectomy was performed using a modified nomogram. All eyes received a single intraoperative application of MMC (0.02%) after laser ablation for the above specified durations.

MAIN OUTCOME MEASURES

Best-corrected visual acuity and corneal haze score.

RESULTS

Best-corrected visual acuity was 20/23 in group 1, 20/20 in group 2, and 20/21 in group 3. The mean haze score+/-standard deviation (scale, 0.00-4.00) was 0.11+/-0.31 in group 1, 0.14+/-0.28 in group 2, and 0.07+/-0.20 in group 3 throughout a mean follow-up of 31 months in group 1, 16 months in group 2, and 10 months in group 3. No eyes had a haze score of more than 1.00.

CONCLUSIONS

There was no statistically significant difference in postoperative best-corrected visual acuity or haze scores among the 3 groups. Administration of prophylactic MMC 0.02% for 12 seconds after PRK seems to be equally efficacious for haze prophylaxis when compared with longer application times of 60 and 120 seconds.

摘要

目的

研究丝裂霉素 C(MMC)0.02%作用时间对行预防性 MMC 应用的准分子激光屈光性角膜切削术(PRK)患者术后视力结果或角膜上皮下混浊发生率的影响。

设计

回顾性、对照病例系列研究。

参与者

269 只眼行 PRK。

方法

这是一项回顾性对照病例系列研究,纳入 269 只眼行 PRK 联合预防性 MMC 应用:120 秒(组 1,n=74)、60 秒(组 2,n=36)或 12 秒(组 3,n=159)。组 1 术前平均等效球镜为-6.49 屈光度(D),组 2 为-6.77 D,组 3 为-7.10 D。PRK 采用改良的列线图进行。所有眼在激光消融后均接受单次术中 MMC(0.02%)应用,时间如上所述。

主要观察指标

最佳矫正视力和角膜混浊评分。

结果

组 1 的最佳矫正视力为 20/23,组 2 为 20/20,组 3 为 20/21。组 1 的平均混浊评分(范围:0.00-4.00)为 0.11±0.31,组 2 为 0.14±0.28,组 3 为 0.07±0.20,随访时间分别为 31 个月、16 个月和 10 个月。无 1 只眼的混浊评分超过 1.00。

结论

3 组间术后最佳矫正视力或混浊评分无统计学差异。与 60 秒和 120 秒较长应用时间相比,PRK 后应用预防性 MMC 0.02% 12 秒似乎同样能有效预防混浊。

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