高度近视行Trans-PRK术中联合MMC对术后haze的影响
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辽宁省科学技术计划项目(No.20180550976); 辽宁省自然科学基金项目(No.2020-MS-339); 大连市科技创新基金项目(No.2019J13SN105)


Effect of intraoperative Trans-PRK combined with MMC on postoperative haze in the treatment of high myopia
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Science and Technology Guidance Plan Project of Liaoning Province(No.20180550976); Natural Science Foundation of Liaoning Province(No.2020-MS-339); Science and Technology Innovation Fund Project of Dalian(No.2019J13SN105)

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    摘要:

    目的:评价经上皮准分子激光角膜切削术(Trans-PRK)联合0.02%丝裂霉素C(MMC)治疗高度近视预防角膜上皮下雾状混浊(haze)的临床效果。

    方法:回顾性病例分析。收集我院2016-01/2017-12行Trans-PRK手术治疗的高度近视患者89例142眼,其中94眼联合使用0.02% MMC设为MMC组,MMC的使用时间为30~45s; 48眼未使用MMC设为对照组。两组患者术后均规律使用类固醇激素滴眼液治疗4mo,随访6mo。采用树模型分析探讨不同相关因素与haze发生的相关性。

    结果:按照Fantes分级进行haze评估。MMC组术后haze发生率为8.5%(8/94),对照组为33.3%(16/48)(P=0.001)。树模型结果显示,切削光区直径和切削深度是haze发生的主要相关因素(P<0.01)。当切削光区直径≤5.6mm时发生haze的可能性越大,当切削光区直径>5.6mm时,最大切削深度成为haze发生的主要影响因素。

    结论:对于薄角膜及角膜形态异常的高度近视患者,在选择Trans-PRK治疗时应考虑切削光区直径及切削深度,同时应联合使用0.02% MMC,可以安全有效地减少haze发生。

    Abstract:

    AIM:To evaluate the mitomycin-C(MMC)0.02% efficacy in preventing haze after trans-epithelial photorefractive keratectomy(Trans-PRK)in the treatment of the high myopia.

    METHODS: Retrospective case series. Trans-PRK were performed on 142 eyes with a preoperative spherical equivalent. They were divided into with 0.02% MMC(MMC group)and without MMC(control)groups. In MMC group there were 94 eyes with MMC 0.02%; in control group there were 48 eyes. Patients were treated with an intraoperative application of MMC 0.02% for 30-45s depending on refractive error in MMC group. After surgery, fluorometholone 0.1% eye drops were used for 4mo in all groups. The mean follow-up time was 6mo. The regression trees were used to analyse the relationship between different related factors and haze.

    RESULTS:Haze was quantified with Fantes. Incidence of haze was 8.5% eyes in MMC group and 33.3% in without MMC group(P=0.001). In the regression trees, optical zone and ablation depth MAX were related to haze(P<0.01). It was possibility induce haze when optical zone is ≤5.6mm. When optical zone is >5.6mm, ablation depth MAX becomes the main factor for haze.

    CONCLUSION: The design of optical zone and ablation depth MAX in Trans-PRK should be considered for the treatment of the high myopia with thin cornea and abnormal corneal morphology. MMC 0.02% was effective in preventing haze after Trans-PRK in the treatment of the high myopia.

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靳琳,张铎龄,于春晶,等.高度近视行Trans-PRK术中联合MMC对术后haze的影响.国际眼科杂志, 2021,21(8):1490-1493.

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  • 收稿日期:2020-11-22
  • 最后修改日期:2021-07-07
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  • 在线发布日期: 2021-07-21
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