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机械性角膜表层切削术治疗丝裂霉素 C 联合角膜上皮下磨镶术及长戴接触镜后角膜混浊

Mechanical superficial keratectomy for corneal haze after photorefractive keratectomy with mitomycin C and extended wear contact lens.

机构信息

Khatam-al-Anbia Eye Hospital, Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Khorasan, Iran.

出版信息

Cornea. 2011 Feb;30(2):117-20. doi: 10.1097/ICO.0b013e3181d5d920.

Abstract

PURPOSE

To evaluate the clinical results of a mechanical keratectomy with mitomycin C (MMC) and extended wear contact lens (EWCL) for the treatment of corneal haze after photorefractive keratectomy (PRK) of high myopia.

SETTING

Eye Research Center, Khatam-al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Iran.

METHODS

: In a retrospective interventional case series, we enrolled 15 eyes of 9 patients who previously underwent PRK for high myopia and developed corneal haze and regression. Mechanical removal of corneal haze was done by using a surgical blade number 15. Then, MMC (0.02%) was used for 2 minutes. An EWCL was applied for 1 month. The main outcome measures were uncorrected visual acuity, best-corrected visual acuity, spherical equivalent (SE), and corneal haze grade. All patients were followed for a minimum of 6 months.

RESULTS

The mean age of the patients was 25.66 ± 7.03 years; 7 patients were men and 2 patients were women. The mean best-corrected visual acuity before superficial keratectomy was 20/80 (range, 20/200-20/50) and improved to 20/20 after treatment (P < 0.05). Thirteen eyes (86.6%) achieved an uncorrected visual acuity of at least 20/40. The mean preoperative SE was 3.91 ± 1.30, and the mean final postoperative SE was -0.85 ± 1.19 (P < 0.05). Eight eyes (53%) were within 1 diopter of emmetropia. Corneal haze in all patients declined to a trace haze or complete clearness. No recurrence occurred during the mean follow-up time of 12 months.

CONCLUSIONS

Superficial keratectomy with MMC and EWCLs is effective in reducing persistent and refractory corneal haze after PRK.

摘要

目的

评估机械性角膜切除术联合丝裂霉素 C(MMC)和延长佩戴接触镜(EWCL)治疗高度近视 PRK 术后角膜混浊和回退的临床效果。

设置

伊朗马什哈德医科大学哈塔姆安比亚眼科医院眼研究中心。

方法

回顾性病例系列研究,纳入 9 例(15 只眼)患者,这些患者先前因高度近视接受 PRK 治疗,术后出现角膜混浊和回退。采用手术刀片 15 号进行角膜混浊物机械清除,然后用 MMC(0.02%)作用 2 分钟。应用 EWCL 治疗 1 个月。主要观察指标为未矫正视力、最佳矫正视力、等效球镜(SE)和角膜混浊分级。所有患者均至少随访 6 个月。

结果

患者的平均年龄为 25.66±7.03 岁;7 例为男性,2 例为女性。行浅层角膜切削术前平均最佳矫正视力为 20/80(20/200~20/50),术后提高至 20/20(P<0.05)。13 只眼(86.6%)获得至少 20/40 的未矫正视力。术前 SE 平均为 3.91±1.30,术后平均最终 SE 为-0.85±1.19(P<0.05)。8 只眼(53%)屈光度在 1 个屈光度以内。所有患者的角膜混浊均减轻至痕迹混浊或完全清晰。平均 12 个月随访期间无复发。

结论

PRK 术后应用 MMC 和 EWCL 行浅层角膜切削术可有效减轻持续性和难治性角膜混浊。

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