准分子激光上皮瓣下角膜磨镶术后中央角膜厚度切削变动的临床观察  

Clinical observation of cutting fluctuations on central corneal thickness after laser subepithelial keratomileusis

作　　者：承伟[1] 浦利军 臧亚芳[1] 姜莹莹[1] Wei Cheng Li- Jun Pu Ya-Fang Zang Ying- Ying Jiang(Department of Ophthalmology, Sooehow University Affiliated Zhangjiagang Hospital, Zhangjiagang First People＇s Hospital, Zhangjiagang 215600, Jiangsu Province, China)

机构地区：[1]苏州大学附属张家港医院张家港市第一人民医院眼科,中国江苏省张家港市215600

出　　处：《国际眼科杂志》2017年第9期1693-1696,共4页International Eye Science

摘　　要：目的:探讨准分子激光上皮瓣下角膜磨镶术(laserassisted subepithelial keratomileusis,LASEK)术中联合低浓度(0.2g/L)丝裂霉素C(MMC)局部应用后中央角膜厚度(central corneal thickness,CCT)切削变动百分率的变化。方法:前瞻性分析2009-03/2014-11于我院行LASEK治疗近视的患者220例440眼,其中低、中度组(等效球镜≤6.0DS)138例276眼,高度组(6.0DS<等效球镜≤10.0DS)82例164眼。术前根据随机表法分别将两组患者均分为试验组和对照组,试验组:切削后双眼使用0.2g/L MMC均质棉片浸润基质面;对照组:双眼均行常规手术。采用变异系数(CV)评估参数重复性,组内及组间数据比较采用配对样本t检验分析。结果:中央角膜厚度及切削值,术后3mo各组间差异均有统计学意义(P<0.05)。避免受个体中央角膜厚度差异的干扰采用角膜切削变动百分率:术后1mo角膜切削变动百分率最低,术后3mo角膜切削变动百分率最高,与该组术后其它各期角膜切削变动百分率差异均有统计学意义(P<0.05);各组对照组和试验组术后各期角膜切削变动百分率组间差异均有统计学意义(P<0.05)。结论:中央角膜厚度切削变动百分率的观察研究,进一步表明低浓度MMC具有减轻术后角膜前基质层增殖反应、抑制haze产生的作用。AIM： To evaluate the percentage of cutting fluctuations of central corneal thickness （CCT） intraoperative used low concentration （0.02%） mitomycin C （MMC） after laser- assisted subepithelial keratomileusis （LASEK）. METHODS： In this prospective study, low and medium myopia group （ spherical equivalent 〈 6. 0DS） has 138 patients （276 eyes）. Low concentration MMC used topically in 69 patients（138 eyes） randomized after excimer laser ablation; the another traditional LASEK as control. High myopia group（6.0DS〈spherical equivalent〈10.0DS） has 82 patients （164 eyes）. Low concentration MMC used topically in 41 patients （82 eyes）, the another traditional LASEK as control. The different measured value and percent of change between actual CCT and predicted CCT were recorded at I, 2, 3, 6, 9 and 12mo after LASEK. Corneal parameters were compared using paired t test and their repeatability was assessed using the coefficient of variation （ C. RESULTS： At 3mo after operation, the difference of central corneal thickness and cutting value between different treatment groups was statistically significant（P〈 0.05）. The percentage of cutting fluctuations, which used to avoid the interference of the individual central corneal thickness between the applying low concentration MMCgroup and control group： the minimum value achieved at 1too after LASEK, the maximum value achieved at 3mo after LASEK, the difference was statistically significant compared with the other 5 periods after LASEK within group（P〈0.05） ; the difference in each period after LASEK was statistically significant（P〈0.05） between groups with different treatmemt（P〈0.05）. CONCLUSION： The study on percentage of cutting fluctuations of central corneal thickness, further confirmed low concentrations MMC in reducing postoperative corneal stromal proliferation reaction, inhibition of haze production.

关 键 词：准分子激光 丝裂霉素C 中央角膜厚度 

分 类 号：R779.63[医药卫生—眼科]