Trans-PRK联合0.02% MMC对中度近视患者角膜光密度的影响  

Effect of Trans-PRK combined with 0.02 % MMC on corneal density in patients with moderate myopia

作　　者：裴天序 靳琳 于春晶 牟亚男 闫春晓 宁吉良 陈若语 邢泽群 孙思宇 张立军 Tian-Xu Pei;Lin Jin;Chun-Jing Yu;Ya-Nan Mu;Chun-Xiao Yan;Ji-Liang Ning;Ruo-Yu Chen;Ze-Qun Xing;Si-Yu Sun;Li-Jun Zhang(Department of Ophthalmology,the Third People's Hospital of Dalian Medical University,Dalian 116033,Liaoning Province,China;Dalian Medical University,Dalian 116023,Liaoning Province,China)

机构地区：[1]大连医科大学附属大连市第三人民医院眼科,辽宁省大连市116033 [2]大连医科大学,辽宁省大连市116023

出　　处：《国际眼科杂志》2022年第8期1345-1351,共7页International Eye Science

基　　金：辽宁省自然科学基金指导计划项目(No.20180550976);辽宁省自然基金资助计划项目(No.2020-MS-339);大连市科技创新基金项目(No.2019J13SN105);大连市高层次人才创新支持计划项目(No.2021RQ033);大连市医学科学研究计划项目(No.2111008,1911032)。

摘　　要：目的:评价经上皮准分子激光角膜切削术(Trans-PRK)联合0.02%丝裂霉素C(MMC)对中度近视患者角膜光密度的影响。方法:回顾性病例分析。选择我院2021-01/06行Trans-PRK手术治疗的中度近视患者28例56眼,MMC组28眼术中联合使用0.02%MMC 20s;对照组28眼术中未使用MMC。于术前,术后14d, 1、3mo分别使用Pentacam眼前节分析仪测量不同直径范围及不同厚度分层范围内角膜光密度值。结果:MMC组总角膜光密度值术前为16.60(15.70,17.10),术后14d为16.63(15.90,17.50)、术后1mo为16.57(15.10,16.70),术后3mo为16.04(14.60,16.60);对照组总角膜光密度值术前为16.30(15.50,17.30),术后14d为16.20(15.20,17.10)、术后1mo为16.08(14.90,16.40)、术后3mo为15.60(14.60,16.40)。两组患者手术前后以角膜顶点为中心0~2mm直径范围术后14d角膜光密度值较术前升高(P<0.001),在直径2~6mm内术后1、3mo角膜光密度值较术前升高(P<0.001),在直径6~10mm内角膜光密度术后14d, 1、3mo角膜光密度值较术前升高(P<0.01);两组患者角膜前120μm厚度角膜光密度值术后1、3mo角膜光密度值较术前降低(P<0.01),在中部厚度术后1mo角膜光密度值较术前降低(P<0.01)。结论:术中使用0.02%MMC可在术后早期一定程度上降低角膜光密度值,增加角膜通光性。术后不同时间段观察不同范围内角膜光密度值变化可有效量化haze的发生和转归。AIM: To evaluate the effect of 0.02% mitomycin-C(MMC) on the corneal density after transepithelial photorefractive keratectomy(Trans-PRK). METHODS: Retrospective case analysis. Selected 28 patients with 56 eyes in moderate myopia who underwent Trans-PRK surgery from January 2021 to June 2021 in our hospital. They were divided into MMC group in 28 eyes with a combination of 0.02% MMC 20 s during the surgery and the control group in 28 eyes was not use MMC during the surgery. The Pentacam anterior segment analyzer was used to measured the corneal density in different diameter ranges and different thickness layers before and after surgery at 14 d, and after surgery at 1 and 3 mo.RESULTS: The total corneal density value of MMC group was 16.60(15.70,17.10) before the surgery, after the surgery at 14 d was 16.63(15.90,17.50), at 1 mo was 16.57(15.10,16.70), at 3 mo was 16.04(14.60,16.60). The total corneal density value of control group was 16.30(15.50,17.30) before the surgery, after the surgery at 14 d was 16.20(15.20,17.10), at 1 mo was 16.08(14.90,16.40) and at 3 mo was 15.60(14.60,16.40). In the zone of 0-2 mm diameter was centered on the corneal vertex, the corneal density of the two groups at 14 d after the surgery was higher than those before surgery(P<0.001). In the zone of 2-6 mm diameter, the corneal density of the two groups at 1 mo and 3 mo after surgery was higher than those before the surgery(P<0.001). In the zone of 6-10 mm, the corneal density of the two groups at 14 d, 1 and 3 mo after surgery was higher than those before the surgery(P<0.001). In the layer of anterior 120 μm, the corneal density of the two groups at 1 mo and 3 mo after the surgery was decreased than that before surgery(P<0.01). In the middle layer, the corneal density of the two groups at 1 mo after the surgery was decreased than those before surgery(P<0.01).CONCLUSION:The use of 0.02% MMC during the operation can reduce the corneal density and increase the corneal light transmittance in the early postoperative period. The occurrence

关 键 词：经上皮准分子激光角膜切削术(Trans-PRK) 丝裂霉素C(MMC) 角膜上皮下雾状混浊 角膜光密度 

分 类 号：R779.63[医药卫生—眼科]