丝裂霉素C在准分子激光上皮下角膜磨镶术中应用对眼压影响的临床研究

The effect of mitomyc in C on intraocular oressure in laser-assisted subepithelial keratomileusis

目的探讨丝裂霉素C(MMC)在准分子激光上皮下角膜磨镶术(LASEK)术中应用对眼压的影响。方法在术前和术后第1、4周及第12周,分别采用非接触式眼压计(NCT)和Goldmann眼压计(GAT)测量接受LASEK治疗的对照组和MMC组近视患者各150只眼的眼内压。结果术前MMC组和对照组NCT眼压值分别为(15.77±1.90)mmHg和(15.60±2.11)mmHg;术前MMC组和对照组GAT眼压值分别为(16.21±1.90)mmHg和(15.90±2.11)mmHg。术后第1、4周及第12周MMC组和对照组NCT眼压值分别下降至(14.44±1.60)mmHg、(14.62±1.47)mmHg、(14.51±1.87)mmHg和(14.62±1.47)mmHg、(14.94±1.34)mmHg、(14.66±1.54)mmHg;术后第1、4周及第12周MMC组和对照组GAT眼压值分别下降至(14.35±1.58)mmHg、(14.42±1.38)mmHg、(14.75±1.80)mmHg和(14.76±1.47)mmHg、(14.84±1.32)mmHg、(14.55±1.45)mmHg。手术前后眼压差异有统计学意义。对照组和MMC组术前和术后第1、4周及第12周NCT和GAT眼压值,差异均无统计学意义(P>0.05)。结论LASEK术后压平式眼压计眼压测量值偏低,按传统正常值衡量眼压测量结果可能延误皮质类固醇性青光眼的早期诊断。MMC对LASEK术后眼压无明显影响。

Objective The development of laser-assisted subepithelial keratomileusis （LASEK） technique and application of mitomycin C have improved the operation outcome and broadened the operative indicators. This study tried to explore the effects of mitomycin C on Intraocular Pressure in laser-assisted subepithelial keratomileusis（LASEK）. Methods 300 eyes of 150myopic patients admitted in our hospital were included in this study. The left and right of eyes of 150 patients was randomly divided into two groups,0.02% MMC sponge was put on to the cornea ablation area in 2 minutes during the operation in 150 eyes of MMC group;BBS sponge was put on to the cornea ablation area in 2 minutes during the operation in 150 eyes of the control group. Subsequently the corneal area was completely rinsed and the corneal endothelium then was put back.IOP was measured with NCT and GAT before operation and1,4 and 12 weeks after operation.Results After LASEK,a significant decrease was observed in NCT and GAT measurements. There were no significant differences in IOP between the control group and MMC group（P0.05）after operation. Conclusion The applanation tonometer appears to underestimate the true IOP after LASEK. The GAT and NCT measurements after LASEK can not be judged by the normal value in tradition,which will delay early diagnosis of steroid glaucoma after LASEK.The application of mitomycin C in LASEK has no effect on the IOP.