[关键词]
[摘要]
目的：探讨准分子激光屈光性角膜切削术(photorefractive keratectomy，PRK)联合术中使用0.2g/L丝裂霉素(MMC)矫治高度近视的安全性、有效性、稳定性。
方法：对109例201眼高度近视的患者行PRK术，激光切削后使用0.2g/L MMC 20s，观察术后角膜上皮愈合时间、观察术后1，3，6，12mo时裸眼视力、矫正远视力、屈光状态、haze形成情况及并发症情况、角膜内皮细胞计数等。
结果：角膜上皮愈合时间为3.68±0.35d。术后裸眼视力均有明显提高，术后12mo裸眼视力达到1.0以上的者189眼(94%)，等效球镜在±0.5D以内者153眼(76%)。术后矫正远视力下降1行者7眼(3%)，无1例矫正远视力下降2行或2行以上。术后3mo与术后12mo相比，屈光度变化≤0.5D者占96%。手术前后角膜内皮细胞计数、变异系数比较均无显著性差异(P1=0.71； P2=0.83)。术后12mo，0～0.5级haze者189眼(94%)，1级haze者12眼(6%)； 未见2级以上haze。术后未见丝裂霉素毒性反应及并发症。
结论：准分子激光屈光性角膜切削术联合术中使用0.2g/L MMC 20s矫治高度近视安全、有效。
[Key word]
[Abstract]
AIM: To evaluate the efficacy, safety and stability of photorefractive keratectomy(PRK)for high myopia with 0.2g/L mitomycin C(MMC).
METHODS: Totally 109 patients(201 eyes)after PRK were treated with intraoperative application of 0.2g/L MMC for 20 seconds. The recovery of cornea epithelium after surgery was regularly observed. The uncorrected visual acuity(UCVA), corrected distance visual acuity(CDVA), refraction, haze, complications and endothelial cell counts 1 month, 3, 6, 12 months after PRK were compared.
RESULTS:The time of corneal epithelium recovery was 3.68±0.35 days. All eyes had a significant increase in UCVA. 12 months after surgery, 189 eyes(94%)achieved UCVA better than 1.0 and 153 eyes(76%)had a spherical equivalent(SE)within±0.5D. 7 eyes(3%)lost one line of CDVA. No one lost 2 or more lines of CDVA. Ninety-six percent eyes changed within±0.5D when comparing 3 month and 12 month. Postoperative endothelial cell density and coefficient of variability(CV)did not show a significant difference from preoperative measurements(P1=0.71; P2=0.83). Haze of grade 1 occurred in 12 eyes(6%)and haze between grade 0.5 and 1 existed in 189 eyes(94%)at 12 months. No eye developed haze over grade 2. No toxic effect and complications of MMC were found after surgery.
CONCLUSION: PRK with intraoperative application of MMC for 20 seconds appears to be a safe and effective method for correction of high myopia.
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