丝裂霉素C在Epi-LASIK术矫正高度和超高度近视中的应用

Clinical study of applying mitomycin C in Epi-LASIK surgery for treatment of middle and high myopia

目的:观察丝裂霉素C(mitomycin C,MMC)应用于机械法—准分子激光上皮瓣下角膜磨镶术(epipdisaser in situ keratomileusis,Epi-LASIK)术矫正高度和超高度近视中的疗效。方法:将高度和超高度近视204例408眼随机分为两组,MMC组102例204眼;对照组102例204眼。所有手术皆运用AMOAmadeus Ⅱ Microkeratome直线式角膜上皮刀制作角膜上皮瓣,MMC组术中激光切削后置0.2g/LMMC棉片于基质床60-90s;对照组除不置MMC外余操作相同。术后随访两组角膜上皮瓣愈合时间、术后刺激症状、haze反应及裸眼视力。结果:所有患者均顺利完成手术。MMC组和对照组Epi-LASIK术后刺激症状皆轻微,316眼(77.4%)疼痛评分为0～1分。角膜上皮瓣愈合时间为3～6d。术后6mo查MMC组中199眼(97.5%)UCVA达到并超过BCVA;对照组168眼(82.4%)UCVA达到并超过BCVA;MMC组视力回退者5眼(2.5%),对照组视力回退者36眼(17.6%)。术后6mohaze反应MMC组与对照组对比,haze2级及haze2级以上差异有显著性(P<0.05),有统计学意义。结论:Epi-LASIK术矫正高度和超高度近视中应用0.2g/LMMC对减轻haze的形成、防止视力回退安全有效。

AIM： To observe the effect of mitomycin C in Epi-LASIK surgery for treatment of middle and high myopia.METHODS：The 408 eyes of 204 patients was randomly divided into two groups. All of surgeries were finished with AMO Amadeus Ⅱ Microkeratome. 0. 2g/L MMC sponge was put on to the cornea ablation area in 60-90 seconds during the operation in 204 eyes of MMC group; nothing with compare group. The others operate were identical. Regular follow-up of the two groups was done to observe the stimulate formation, cornea epithelium healing time, the formation of haze and UCVA. RESULTS： All of surgery had been finished success- fully. Stimulate formation were light in MMC groups and compare groups, 316 eyes （77. 4%） had marked 0-1. There need 3-6 days for cornea epithelium healing. 199 eyes（97.5%） in MMC groups reached the best expected visual acuity 6 months after surgery, compare groups were 168 eyes （82.4%）.5 eyes（2.5%） UCVA felled in MMC groups and 36 eyes（17.6%） in compare groups. Compared the haze formation in eyes were MMC groups and compare groups , there were statistically significant difference of second grade and more than second grade in two groups after 6 months （P〈0.01）.CONCLUSION： The application of 0.2g/L MMC during Epi-LASIK operation for treatment of middle and high myopia was safe, effective treatment. It could reduce the formation of haze and prevent UCVA falling.