中高度近视患者在TransPRK中使用丝裂霉素C预防角膜上皮下混浊的临床研究  

Clinical study on the use of mitomycin C in TransPRK for haze prevention in patients with moderate and high myopia

作　　者：黄欢[1] 沈孝军[1] 刘玉爱[1] 罗小柳[1] 吴秀匀[1] 吕顺欢[1] HUANG Huan;SHEN Xiaojun;LIU Yu’ai;LUO Xiaoliu;WU Xiuyun;LYU Shunhuan(Department of Ophthalmology,Jiangmen Central Hospital,Jiangmen 529030,Guangdong,China)

机构地区：[1]江门市中心医院眼科,广东江门529030

出　　处：《中国现代医生》2023年第24期92-95,101,共5页China Modern Doctor

基　　金：江门市科技计划项目(2021YL01088)

摘　　要：目的观察行经上皮准分子激光角膜切削术(trans-epithelial photorefractive keratectomy,TransPRK)的中高度近视患者使用丝裂霉素C(mitomycinC,MMC)预防角膜上皮下混浊的有效性及安全性。方法将2021年4月至2022年10月45例在江门市中心医院眼科门诊行Trans PRK的中高度近视患者(等效球镜度–3.75~–9.00D)分成两组:研究组21例(42只眼)术中使用MMC;对照组24例(48只眼)不使用MMC,术后两组用药方案一致,观察患者术后4d、术后1、3、6、12个月的裸眼视力、角膜曲率、角膜内皮细胞密度及角膜上皮下混浊的发生率。结果两组患者术后不同时期的裸眼视力、角膜曲率、角膜内皮细胞密度比较,差异无统计学意义(P>0.05);术后两组患者的角膜上皮下混浊的发生率比较,差异有统计学意义(χ^(2)=16.364,P<0.001;χ^(2)=7.666,P=0.006;χ^(2)=7.683,P=0.006)。结论TransPRK的中高度近视患者使用MMC预防角膜上皮下混浊效果良好,长期观察安全性高,对角膜内皮并无影响。Objective To observe the efficacy and safety of mitomycin C(MMC)in the prevention of haze in patients with moderate and high myopia who received trans-epithelial photorefractive keratectomy(TransPRK).Methods Totally 45 patients with moderate to high myopia(equivalent sphere optometry-3.75 to-9.00D)who underwent TransPRK in the ophthalmology clinic of Jiangmen Central Hospital were randomly divided into two groups by surgeons from April 2021 to October 2022.21 patients(42 eyes)were treated with MMC during operation in the study group,and 24 patients(48 eyes)were treated without MMC in the control group.The uncorrected visual acuity,corneal curvature,corneal endothelial cell density and the incidence of haze were observed at 4 days,1 month,3 months,6 months and 1 year after operation.Results There were no significant differences in visual acuity,corneal curvature and corneal endothelial cell density between the two groups(P>0.05).There was a significant difference in the incidence of haze between the two groups(χ^(2)=16.364,P<0.001;χ^(2)=7.666,P=0.006;χ^(2)=7.683,P=0.006).Conclusion The use of MMC in TransPRK for haze prevention is effective and safe for long-term observation.It has no effect on corneal endothelium.

关 键 词：中高度近视 丝裂霉素C 经上皮准分子激光角膜切削术 角膜上皮下混浊 

分 类 号：R778[医药卫生—眼科]