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体内PRK治疗后伏立诺他与丝裂霉素C在降低角膜混浊风险方面的疗效与安全性比较

Efficacy and Safety Comparison Between Suberoylanilide Hydroxamic Acid and Mitomycin C in Reducing the Risk of Corneal Haze After PRK Treatment In Vivo.

作者信息

Anumanthan Govindaraj, Sharma Ajay, Waggoner Michael, Hamm Chuck W, Gupta Suneel, Hesemann Nathan P, Mohan Rajiv R

出版信息

J Refract Surg. 2017 Dec 1;33(12):834-839. doi: 10.3928/1081597X-20170921-02.

Abstract

PURPOSE

This study compared the efficacy and safety of suberoylanilide hydroxamic acid (SAHA) and mitomycin C (MMC) up to 4 months in the prevention of corneal haze induced by photorefractive keratectomy (PRK) in rabbits in vivo.

METHODS

Corneal haze in rabbits was produced with -9.00 diopter PRK. A single application of SAHA (25 μM) or MMC (0.02%) was applied topically immediately after PRK. Effects of the two drugs were analyzed by slit-lamp microscope, specular microscope, TUNEL assay, and immunofluorescence.

RESULTS

Single topical adjunct use of SAHA (25 μM) or MMC (0.02%) after PRK attenuated more than 95% corneal haze and myofibroblast formation (P < .001). SAHA did not reduce keratocyte density, cause keratocyte apoptosis, or increase immune cell infiltration compared to MMC (P < .01 or .001). Furthermore, SAHA dosing did not compromise corneal endothelial phenotype, density, or function in rabbit eyes, whereas MMC application did (P < .01 or .001).

CONCLUSIONS

SAHA and MMC significantly decreased corneal haze after PRK in rabbits in vivo. SAHA exhibited significantly reduced short- and long-term damage to the corneal endothelium compared to MMC in rabbits. SAHA is an effective and potentially safer alternative to MMC for the prevention of corneal haze after PRK. Clinical trials are warranted. [J Refract Surg. 2017;33(12):834-839.].

摘要

目的

本研究比较了伏立诺他(SAHA)和丝裂霉素C(MMC)在长达4个月的时间里对兔体内准分子激光角膜切削术(PRK)诱导的角膜混浊的预防效果及安全性。

方法

用-9.00屈光度的PRK在兔眼中制造角膜混浊。PRK术后立即局部单次应用SAHA(25μM)或MMC(0.02%)。通过裂隙灯显微镜、角膜内皮显微镜、TUNEL检测和免疫荧光分析两种药物的效果。

结果

PRK术后单次局部应用SAHA(25μM)或MMC(0.02%)可使角膜混浊和肌成纤维细胞形成减少95%以上(P <.001)。与MMC相比,SAHA不会降低角膜细胞密度、引起角膜细胞凋亡或增加免疫细胞浸润(P <.01或.001)。此外,SAHA给药不会损害兔眼角膜内皮表型、密度或功能,而MMC应用则会(P <.01或.001)。

结论

SAHA和MMC在兔体内可显著降低PRK术后的角膜混浊。与MMC相比,SAHA对兔眼角膜内皮的短期和长期损伤明显减少。SAHA是预防PRK术后角膜混浊的一种有效且可能更安全的MMC替代药物。有必要进行临床试验。[《屈光手术杂志》。2017;33(12):834 - 839。]

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