Adib-Moghaddam Soheil, Soleyman-Jahi Saeed, Tefagh Ghazale, Tofighi Salar, Grentzelos Michael A, Kymionis George D
J Refract Surg. 2018 Jun 1;34(6):400-407. doi: 10.3928/1081597X-20180402-02.
To compare efficacy and safety of single-step transepithelial photorefractive keratectomy (PRK) with or without mitomycin C (MMC) in patients with mild to moderate myopia.
Patients with mild to moderate myopia (≤ -5.50 diopters [D]) underwent single-step transepithelial PRK using the Amaris laser (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany). Total ablation depth (epithelium and stroma) was 160 μm or less. The right eye of each patient was treated with 0.02% MMC for 10 seconds, whereas the left eye did not receive any MMC. Corneal haze, endothelial cell indices, refraction, visual acuity, contrast sensitivity, and higher order aberrations were assessed preoperatively and postoperatively.
In this comparative case series, 71 patients (16 men and 55 women; 142 eyes) were enrolled. Mean patient age was 27.97 ± 5.74 years. Mean preoperative spherical equivalent of patients' right and left eyes were -3.20 ± 1.20 and -3.30 ± 1.20 diopters, respectively (P = .70); other preoperative visual parameters were also comparable. Incidence of 2+ grade of haze was detected in 1 (2.5%) right and 2 (5.0%) left eyes (P > .99) 3 to 6 months postoperatively. Incidence of 1+ degree of haze was also comparable. No eye developed 3+ degrees or more of haze. One year postoperatively, both eyes achieved comparable refraction, visual acuity, contrast sensitivity, and higher order aberrations, and no greater than trace haze was detected. MMC-treated eyes suffered a greater loss of endothelial cell density (P < .001) and showed higher variance in cell size (P = .001).
Single-step transepithelial PRK with or without MMC showed similar efficacy and incidence of haze in eyes with mild to moderate myopia with total ablation depths of 160 μm or less. However, MMC-treated eyes showed a worse profile of endothelial cell indices. Applications of MMC in this subgroup of patients may be reconsidered. [J Refract Surg. 2018;34(6):400-407.].
比较单步经上皮准分子激光角膜切削术（PRK）联合或不联合丝裂霉素C（MMC）治疗轻中度近视患者的疗效和安全性。
轻中度近视（≤ -5.50屈光度[D]）患者使用阿玛里斯激光（德国克莱诺施泰姆市SCHWIND眼科技解决方案有限公司）接受单步经上皮PRK治疗。总消融深度（上皮和基质）为160μm或更小。每位患者的右眼用0.02% MMC治疗10秒，而左眼未接受任何MMC。术前和术后评估角膜混浊、内皮细胞指数、屈光、视力、对比敏感度和高阶像差。
在这个比较性病例系列中，纳入了71例患者（16例男性和55例女性；142只眼）。患者平均年龄为27.97 ± 5.74岁。患者右眼和左眼术前平均等效球镜分别为-3.20 ± 1.20和-3.30 ± 1.20屈光度（P = 0.70）；其他术前视觉参数也具有可比性。术后3至6个月，右眼1只（2.5%）和左眼2只（5.0%）检测到2+级混浊（P > 0.99）。1+级混浊的发生率也具有可比性。没有眼睛出现3+级或更高级别的混浊。术后1年，双眼在屈光、视力、对比敏感度和高阶像差方面相当，且未检测到大于微量的混浊。接受MMC治疗的眼睛内皮细胞密度损失更大（P < 0.001），且细胞大小的方差更高（P = 0.001）。
单步经上皮PRK联合或不联合MMC在总消融深度为160μm或更小的轻中度近视眼中显示出相似的疗效和混浊发生率。然而，接受MMC治疗的眼睛内皮细胞指数情况更差。在这一亚组患者中MMC的应用可能需要重新考虑。[《屈光手术杂志》。2018；34(6):400 - 407。]
