LASEK手术中5-氟尿嘧啶不同作用时间对角膜内皮细胞的影响  

Effects of 5-fluorouracil at different exposure time on the corneal endothelial cells in LASEK surgery

作　　者：章圣夫 马雅玲[1] ZHANG Sheng-fu;MA Ya-ling(General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院,银川750004

出　　处：《中国处方药》2023年第5期17-20,共4页Journal of China Prescription Drug

摘　　要：目的研究准分子激光上皮下角膜磨镶术(LASEK)中使用5-氟尿嘧啶(5-FU)防止LASEK术后角膜异常增殖的情况下,对于角膜内皮细胞的影响。方法收集某院2018年6月~2020年8月进行LASEK准分子激光手术的患者,根据术中5-氟尿嘧啶在角膜基质层上的接触时间(t),将研究对象分为A、B两组,其中A组为20 s≤t≤40 s,B组为40 s<t≤60 s。分别于术前及术后1周,1个月、3个月、5个月记录角膜中央及周边区域内皮细胞密度(ECD)、平均细胞面积(ACA)、面积标准差(SD)、变异系数(CV)和六边形细胞百分比(HEX),分析对比两组间这些指标的变化情况。结果本研究共纳入患者88例176眼,A组与B组分别纳入88眼。周边区角膜内皮细胞的ACA、中央区角膜内皮细胞的CV和HEX于术后1周与术前相比差异有统计学意义(P<0.05),其余各指标在各随访时间两组间差异无统计学意义(P>0.05)。结论LASEK术后短期内出现的指标变化,均为一过性改变。在合理时间范围内应用5-氟尿嘧啶,不会对角膜内皮细胞形态造成显著长期影响。Objective To investigate the effect of 5-fluorouracil(5-FU)on corneal endothelial cells LASEK to prevent abnormal corneal proliferation after LASEK.Methods Patients who underwent LASEK excimer laser surgery from June 2018 to August 2020 in a hospital were collected.According to the intraoperative contact time(t)of 5-fluorouracil on the corneal stromal layer,the subjects were divided into two groups,group A was 20 s≤t≤40 s,group B was 40 s<t≤60 s.Endothelial cell density(ECD),mean cell area(ACA),standard deviation of area(SD),coefficient of variation(CV)and percentage of hexagon cells(HEX)in the central and peripheral areas of the cornea were recorded before and after surgery at 1 week,1 month,3 months and 5 months,respectively.The changes of these indexes between the two groups were analyzed and compared.Results A total of 88 patients and 176 eyes were included in this study,with 88 eyes in group A and 88 eyes in group B respectively.ACA of peripheral corneal endothelial cells,CV and HEX of central corneal endothelial cells were significantly differences at 1 week after surgery compared with those before surgery(P<0.05),while other indexes were not significantly difference between the two groups at each follow-up time(P>0.05).Conclusion Changes in indicators occurring in the short term after LASEK were all transient changes.5-fluorouracil application within a reasonable time range will not cause significant long-term effects on the morphology of corneal endothelial cells.

关 键 词：准分子激光上皮瓣下角膜磨镶术 5-氟尿嘧啶 角膜内皮细胞 

分 类 号：R779.63[医药卫生—眼科]