准分子激光上皮下角膜磨镶术联合丝裂霉素C矫正中度近视的临床疗效观察

发布时间：2018-04-20 04:07

  本文选题：LASEK + MMC　； 参考：《广西医科大学》2011年硕士论文

【摘要】：目的:观察准分子激光上皮瓣下角膜磨镶术(LASEK)联合丝裂霉素C(MMC)治疗中度近视手术后裸眼视力、角膜刺激症状、角膜上皮愈合时间、角膜雾状混浊(Haze)的发生情况、对比敏感度及立体视觉,以评价MMC在中度近视LASEK治疗中的有效性及安全性。 方法:对19例36眼等效球镜-3.00～-6.00D中度近视的患者进行LASEK矫正,病例随机分成MMC组及对照组,其中MMC组激光切削后一次性使用体积分数为0.02%的MMC。观察手术前常规指标及手术后裸眼视力、角膜刺激症状评分、角膜上皮愈合时间、角膜Haze发生眼数、对比敏感度函数(CSF)值及立体视锐度(SA)的变化。手术后随访6mo以上。 结果:随着时间的推移,手术后两组的视力逐渐恢复,术后1mo、3mo、6mo,MMC组裸眼视力(UCVA)达到1.0眼数及百分比为12(63.16%)、15(78.95%)、19(100%),而对照组为11(64.71%)、14(82.35%)、17(100%)。手术后1w、2w、1mo、3mo、6mo两组UCVA≥1.0的眼数比较无统计学差异,p0.05。除对照组出现1眼手术后角膜刺激症状评分为3分外,其余两组术眼手术后得分均为1分及以下,手术后两组角膜刺激症状评分比较无统计学差异,p0.05。除对照组有1眼角膜上皮为手术后2周愈合,其余术眼角膜上皮均在手术后7天内愈合,手术后不同时间两组角膜上皮愈合数无统计学差异,p0.05。两组Haze发生数在手术后3个月时明显增多,于6个月时趋于消退。手术后1mo、3mo、6mo,MMC组发生0.5级Haze的眼数为2、7、1,对照组为8、8、2,对应P值分别为0.025、0.736、0.593,手术后1mo两组发生0.5级Haze的眼数有统计学差异,p0.05,对照组0.5级Haze的发生率要高于MMC组。手术后两组发生1级Haze眼数比较无统计学差异,p0.05。两组CSF值在手术后1个月下降,3个月恢复手术前,组内不同时间CSF值比较无统计学差异,p0.05。两组手术前及术后不同时间的CSF值无统计学差异,p0.05。手术前、手术后1mo、3mo、6mo患者立体视锐度均≤60”(弧秒),手术后不同时间两组立体视锐度≤60”(弧秒)的眼数无统计学差异,p0.05。 结论:LASEK矫正中度近视手术中使用0.02%MMC可以有效减轻患者手术后Haze的形成,不增加角膜刺激症状及不延长角膜上皮愈合时间。但手术后两组在裸眼视力、对比敏感度、立体视觉方面无显著性差异。
[Abstract]:Objective: to observe the occurrence of naked eyesight, corneal irritation symptom, corneal epithelial healing time and haze haze after laser supra-flap keratomileusis (LASEK) combined with mitomycin (MMC) in the treatment of moderate myopia. Contrast sensitivity and stereoscopic vision were used to evaluate the efficacy and safety of MMC in the treatment of moderate myopia with LASEK. Methods: LASEK correction was performed in 36 eyes of 19 patients with moderate myopia with equivalent spherical endoscopy. The patients were randomly divided into MMC group and control group. In MMC group, the volume fraction of MMCs was 0.02% after laser ablation. The changes of uncorrected visual acuity, corneal irritation symptom score, corneal epithelial healing time, number of corneal Haze eyes, contrast sensitivity function and stereopsis acuity were observed before and after operation. More than 6mo was followed up after operation. Results: with the passage of time, the visual acuity of the two groups gradually recovered. The uncorrected visual acuity (UCVA) in the MMC group was 1.0 eyes and the percentage was 1263.16%. The number and percentage were 1263.16%, 1578.95% and 1978.95%, respectively, while in the control group, 1164.71%, 1164.71%, 1482.35% and 17100%, respectively. There was no significant difference in the number of eyes with UCVA 鈮，

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