[1]陈子扬,胡艳红,胡俊,等.准分子激光上皮瓣下角膜磨镶术（LASEK）患者应用5-氟尿嘧啶和丝裂霉素C对术后haze及视力的影响[J].眼科新进展,2019,39(9):870-873.[doi:10.13389/j.cnki.rao.2019.0198]
　CHEN Zi-Yang,HU Yan-Hong,HU Jun,et al.Effects of 5-fluorouracil and mitomycin C on postoperative haze and visual acuity in patients treated with laser-assisted subepithelial keratomileusis[J].Recent Advances in Ophthalmology,2019,39(9):870-873.[doi:10.13389/j.cnki.rao.2019.0198]
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准分子激光上皮瓣下角膜磨镶术（LASEK）患者应用5-氟尿嘧啶和丝裂霉素C对术后haze及视力的影响/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年9期
页码:
870-873
栏目:
应用研究
出版日期:
2019-09-05

文章信息/Info

Title:
Effects of 5-fluorouracil and mitomycin C on postoperative haze and visual acuity in patients treated with laser-assisted subepithelial keratomileusis
作者:
陈子扬; 胡艳红; 胡俊; 柯发杰; 陈胜; 冯春燕
350122　福建省福州市，福建中医药大学（陈子扬）；350003　福建省福州市，福建中医药大学附属第二人民医院眼科（胡艳红，胡俊，柯发杰，陈胜，冯春燕）
Author(s):
CHEN Zi-Yang; HU Yan-Hong; HU Jun; KE Fa-Jie; CHEN Sheng; FENG Chun-Yan
Fujian University of Traditional Chinese Medicine(CHEN Zi-Yang),Fuzhou 350122,Fujian Province,China;Department of Ophthalmology,the Second People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine(HU Yan-Hong,HU Jun,KE Fa-Jie,CHEN Sheng,FENG Chun-Yan),Fuzhou 350003,Fujian Province,China
关键词:
准分子激光上皮瓣下角膜磨镶术; 5-氟尿嘧啶; 丝裂霉素C
Keywords:
laser-assisted subepithelial keratomileusis; 5-fluorouracil; mitomycin C
分类号:
R778
DOI:
10.13389/j.cnki.rao.2019.0198
文献标志码:
A
摘要:
目的　探讨准分子激光上皮瓣下角膜磨镶术（laser-assisted subepithelial keratomileusis，LASEK）患者应用5-氟尿嘧啶（5-fluorouracil，5-Fu）和丝裂霉素C（mitomycin C，MMC）对术后haze及视力的影响。方法　回顾性分析我院诊治的72例（144眼）屈光度在-6.50~-9.00 D均接受LASEK治疗的近视患者临床资料。按照患者术中用药情况分为5-Fu组（浓度为25 g·L-1）和MMC组（浓度为0.2 g·L-1）。5-Fu组32例，MMC组40例，两组患者的年龄、性别、术前等效球镜度数及最佳矫正视力比较差异均无统计学意义（均为P＞0.05）。分别于术后1周、1个月、3个月、6个月检查两组患者角膜上皮愈合时间、haze出现和消退时间及haze的分级、最佳矫正视力等。结果　5-Fu组患者上皮愈合时间为（5.26±1.12）d，MMC组为（4.66±1.28）d，两组比较差异无统计学意义（P>0.05），两组患者均未见上皮延迟愈合。术后haze出现时间，5-Fu组与MMC组差异无统计学意义（P＞0.05）；术后MMC组haze消退时间为（62.46±12.83）d，5-Fu组为（88.45±15.36）d，两组差异有统计学意义（P＜0.05）。术后1周和术后3个月两组患者haze分级差异均无统计学意义（均为P＞0.05）；术后2周和术后1个月两组haze分级比较，MMC组均优于5-Fu组，差异均有统计学意义（均为P＜0.05）。术后1周和术后1个月MMC组最佳矫正视力均优于5-Fu组，差异均有统计学意义（均为P＜0.05）；术后3个月两组最佳矫正视力均恢复至术前水平，与术前比较差异均无统计学意义（均为P＞0.05），但两组之间比较差异有统计学意义（P＜0.05）；术后6个月两组最佳矫正视力均优于术前水平，术前术后比较差异均有统计学意义（均为P＜0.05），但两组之间比较差异无统计学意义（P＞0.05）。结论　LASEK术中局部应用抗代谢药物5-Fu和MMC均能提高手术疗效，术后3个月haze基本消退，视力恢复到最佳矫正视力，在目前MMC缺乏的情况下可考虑替代使用5-Fu。
Abstract:
Objective　To explore the effects of 5-fluorouracil(5-Fu) and mitomycin C(MMC) on the postoperative haze and the best corrected visual acuity in patients with laser-assisted subepithelial keratomileusis(LASEK).Methods　The clinical data of 72 patients (144 eyes) of myopia treated with LASEK between -6.50 D and -9.00 D were analyzed retrospectively.The patients were divided into 5-Fu group (25 g·L-1 ) and MMC group (0.2 g·L-1) according to the intraoperative medication.There were 32 patients in 5-Fu group and 40 patients in MMC group.There was no significant difference in age,sex,preoperative equivalent spherical degree and best corrected visual acuity (all P>0.05).At 1 week,1 month,3 months and 6 months after operation,respectively,the healing time of corneal epithelium,the time of appearance and regression of haze,the grading of haze,and the best corrected visual acuity observed.Results　The time of epithelium healing in 5-Fu group was（5.26±1.12）days,MMC group was（4.66±1.28） days.There was no significant differences between the two groups (P>0.05).There were no significant differences between 5-Fu group and MMC group in the time of appearance of haze after operation (P>0.05).The time of haze regression was (62.46±12.83)days in MMC group and (88.45±15.36)days in 5-Fu group.There was significant difference between the two groups (P<0.05).One week and 3 months after operation,there was no significantly difference in haze grade between the two groups (all P>0.05),and the difference between MMC group and 5-Fu group was statistically significant 2 weeks after operation and 1 month after operation (all P<0.05).The best corrected visual acuity of MMC group was better than that of 5-Fu group at 1 week and 1 month postoperatively (P<0.05).Three months after operation,the best corrected visual acuity of the two groups recovered to the best corrected visual acuity before operation (P>0.05),but there was a significant difference between the two groups (P<0.05).At 6 months after operation,the best corrected visual acuity of the two groups was better than that of the best corrected visual acuity before operation(P<0.05),but there was no significant difference between the two groups (P>0.05).Conclusion　Local application of 5-Fu and MMC in LASEK increase the curative effect of the operation.After 3 months,the haze disappeared basically and the visual acuity recover to the best corrected visual acuity.In the absence of MMC at present,the alternative use of 5-Fu can be considered.

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更新日期/Last Update: 2019-08-26