Shi Jianjiang, Yuan Yaoxin, Zhao Suxia, Xu Jianlong, Guo Meng
Department of Ophthalmology, Second Affiliated Hospital of Xingtai Medical College, Xingtai, Hebei 054000, P.R. China.
Exp Ther Med. 2014 Jun;7(6):1591-1594. doi: 10.3892/etm.2014.1642. Epub 2014 Mar 28.
The aim of the present study was to determine the effect of different concentrations of mitomycin C (MMC) administered intraoperatively during laser-assisted subepithelial keratectomy (LASEK) surgery. A total of 261 patients (496 eyes) were randomly divided into two groups: 0.04% MMC treatment group consisting of 133 patients (245 eyes) and the 0.02% MMC treatment group consisting of 128 patients (251 eyes). The MMC solutions were dropped intraoperatively onto the ablation region and the duration was dependent on the preoperative refractive power of the patient's cornea: ≤-3.00 diopters (D), 30 sec; between -3.25 D and -6.00 D, 60 sec; between -6.25 D and -9.00 D, 90 sec and ≥-9.25 D, 110 sec. Postoperative observations included haze formation, visual acuity, changes in refractive power, corneal endothelial cell density and incidence of complications. The one year postoperative incidence of haze differed significantly between the groups (P<0.05). The one week and one year comparisons of postoperative visual acuity also differed significantly between the groups (P<0.05). Postoperative changes in corneal refractive power at one, six and 12 months following surgery significantly differed between the groups (P<0.05). No statistically significant difference was identified between the density of corneal endothelial cells prior to surgery and the density at one, six and 12 months following surgery (P>0.05). Thus, the intraoperative application of 0.04% MMC solution effectively inhibited haze formation and markedly improved the efficacy of LASEK surgery, when compared with that of 0.02% MMC.
本研究的目的是确定在准分子激光上皮下角膜磨镶术（LASEK）手术中术中应用不同浓度丝裂霉素C（MMC）的效果。总共261例患者（496只眼）被随机分为两组：0.04%MMC治疗组，由133例患者（245只眼）组成；0.02%MMC治疗组，由128例患者（251只眼）组成。术中将MMC溶液滴于消融区域，持续时间取决于患者角膜术前屈光度数：≤-3.00屈光度（D），30秒；-3.25 D至-6.00 D之间，60秒；-6.25 D至-9.00 D之间，90秒；≥-9.25 D，110秒。术后观察包括 haze形成、视力、屈光度数变化、角膜内皮细胞密度和并发症发生率。两组之间术后1年haze发生率差异有统计学意义（P<0.05）。两组之间术后1周和1年视力比较差异也有统计学意义（P<0.05）。术后1、6和12个月角膜屈光度数变化在两组之间差异有统计学意义（P<0.05）。术前角膜内皮细胞密度与术后1、6和12个月的密度之间未发现统计学上的显著差异（P>0.05）。因此，与0.02%MMC相比，术中应用0.04%MMC溶液可有效抑制haze形成，并显著提高LASEK手术的疗效。
