Mitomycin C modulation of corneal wound healing after photorefractive keratectomy in highly myopic eyes
Mitomycin C modulation of corneal wound healing after photorefractive keratectomy in highly myopic eyes
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DOI：
10.1016/j.ophtha.2004.07.035
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发表时间：
2005-02-01
期刊：
影响因子：
13.7
通讯作者：
Midena, E
中科院分区：
文献类型：
--
作者：
Gambato, C;Ghirlando, A;Midena, E
目的：目的：评价高度近视眼屈光性角膜切削术（PRK）后局部应用丝裂霉素C（MMC）对角膜伤口愈合（CWH）的作用。（>7屈光度）近视。在每例患者中，一只眼随机分配到术中局部应用0.02%丝裂霉素C的眼内固定，另一只眼用安慰剂治疗。术后，丝裂霉素C治疗的眼睛接受人工泪液（每天3次，在3个月内逐渐减少），而对侧眼用氟米龙钠2%和人工泪液（每天3次，在3个月内逐渐减少）。主要结果测量：裸眼视力（UCVA）和最佳矫正视力（BCVA），对比敏感度，明显屈光，和生物显微镜。使用Pelli-Robson图表确定对比敏感度。结果：平均随访18个月（范围12-36）。没有记录任何副作用或毒性作用。在12个月的随访检查中，丝裂霉素C治疗眼和皮质类固醇治疗眼的UCVA（最小分辨率角的对数）分别为0.4+/-0.48和0.5+/-0.53（P = 0.03）。在1年时，皮质类固醇治疗的眼睛中有20%发生角膜混浊，而丝裂霉素C治疗的眼睛中为0%。在12、24和36个月时，角膜共聚焦显微镜显示未治疗眼的活化角膜细胞和细胞外基质明显更明显（Ps = 0.004、0.024和0.046）。结论：术中局部应用0.02%丝裂霉素C可减少高度近视眼行角膜磨镶术后角膜混浊形成。(C)2005年，美国眼科学会。
Purpose: To evaluate the role of topical mitomycin C in corneal wound healing (CWH) after photorefractive keratectomy (PRK) in highly myopic eyes.Design: Prospective, double-masked, randomized clinical trial.Participants: Seventy-two eyes of 36 patients affected by high (>7 diopters) myopia.Methods: In each patient, one eye was randomly assigned to PRK with intraoperative topical 0.02% mitomycin C application, and the fellow eye was treated with a placebo. Postoperatively, mitomycin C-treated eyes received artificial tears (3 times daily, tapered in 3 months), whereas the fellow eye was treated with fluorometholone sodium 2% and artificial tears (3 times daily, tapered in 3 months).Main Outcome Measures: Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), contrast sensitivity, manifest refraction, and biomicroscopy. Contrast sensitivity was determined using the Pelli-Robson chart. Corneal confocal microscopy documented CWH.Results: Mean follow-up was 18 months (range, 12-36). No side effects or toxic effects were documented. At 12-month follow-up examination, UCVAs (logarithm of the minimum angle of resolution) were 0.4+/-0.48 and 0.5+/-0.53 (P = .03) in mitomycin C-treated eyes and corticosteroid-treated eyes, respectively. At 1 year, corneal haze developed in 20% of corticosteroid-treated eyes, versus 0% of mitomycin C-treated eyes. At 12, 24, and 36 months, corneal confocal microscopy showed activated keratocytes and extracellular matrix significantly more evident in untreated eyes (Ps = 0.004, 0.024, and 0.046, respectively).Conclusion: Topical intraoperative application of 0.02% mitomycin C can reduce haze formation in highly myopic eyes undergoing PRK. (C) 2005 by the American Academy of Ophthalmology.