Evaluation of the prophylactic use of mitomycin-C to inhibit haze formation after photorefractive keratectomy
Evaluation of the prophylactic use of mitomycin-C to inhibit haze formation after photorefractive keratectomy
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DOI：
10.1016/s0886-3350(02)01701-7
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发表时间：
2002-12-01
影响因子：
2.8
通讯作者：
Vacchini, L
中科院分区：
文献类型：
--
作者：
Carones, F;Vigo, L;Vacchini, L
目的：评价预防性使用丝裂霉素C抑制准分子激光屈光性角膜切削术（PRK）治疗中高度近视眼（不适合进行激光原位角膜磨镶术（LASIK））后混浊形成的结果：Carones眼科中心，米兰，意大利.方法：本前瞻性随机盲法研究包括60只连续眼（60例患者）。入选标准为等效球镜矫正度在-6.00至-10.00屈光度（D）之间，角膜厚度不足以允许LASIK手术的残余基质厚度超过250 μ m。根据随机化方案将眼睛分为2组。手术后，研究组的眼睛接受单次术中剂量的丝裂霉素C（0.2 mg/mL）治疗，局部使用浸泡的微海绵，放置在消融区域上，并维持2分钟。对照眼未接受此治疗。评价屈光、裸眼视力（UCVA）、最佳矫正视力（BCVA）和裂隙灯检查角膜混浊（haze）或其他可见并发症的证据。(C)结果：术后无明显毒副作用。在6个月随访期间，研究组中没有眼睛的雾状混浊率高于1;对照组中有19只眼睛（63%）（P = 0.01）。在6个月时，屈光结果的组间差异具有统计学意义（P = 0.05），26只研究组眼睛（87%）和14只对照眼睛（47%）在尝试矫正的+/-0.50 D范围内。在随访期间，研究组的眼睛没有BCVA损失; 7只对照眼在6个月时损失了1至3行（P = .0006）。结论：预防性使用稀释的丝裂霉素C 0.02%溶液，在手术中应用单剂量后，角膜混浊率较低，更好的UCVA和BCVA结果，以及比对照组更准确的屈光结果。
Purpose: To evaluate the results of the prophylactic use of mitomycin-C to inhibit haze formation after excimer laser photorefractive keratectomy (PRK) for medium and high myopia in eyes that were not good candidates for laser in situ keratomileusis (LASIK).Setting: Carones Ophthalmology Center, Milan, Italy.Methods: This prospective randomized masked study comprised 60 consecutive eyes (60 patients). The inclusion criteria were a spherical equivalent correction between -6.00 and -10.00 diopters (D) and inadequate corneal thickness to allow a LASIK procedure with a residual stromal thickness of more than 250 mum. The eyes were divided into 2 groups according to the randomization protocol. After PRK, the study group eyes were treated with a single intraoperative dose of mitomycin-C (0.2 mg/mL), applied topically with a soaked microsponge placed over the ablated area and maintained for 2 minutes. The control eyes did not receive this treatment. Refraction, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and slitlamp evidence of corneal opacity (haze) or other visible complications were evaluated. (C) 2002 ASCRS and ESCRS.Results: No toxic or side effects were encountered postoperatively. No study group eye had a haze rate higher than 1 during the 6-month follow-up; 19 eyes (63%) in the control group did (P = .01). At 6 months, the between-group difference in the refractive outcome was statistically significant (P = .05), with 26 study group eyes (87%) and 14 control eyes (47%) within +/-0.50 D of the attempted correction. No study group eye had a BCVA loss during the follow-up; 7 control eyes had lost 1 to 3 lines at 6 months (P = .0006).Conclusions: The prophylactic use of a diluted mitomycin-C 0.02% solution applied intraoperatively in a single dose after PRK produced lower haze rates, better UCVA and BCVA results, and more accurate refractive outcomes than those achieved in the control group.