本文選題：LASEK + MMC　； 參考：《廣西醫(yī)科大學》2011年碩士論文

【摘要】：目的:觀察準分子激光上皮瓣下角膜磨鑲術(shù)(LASEK)聯(lián)合絲裂霉素C(MMC)治療中度近視手術(shù)后裸眼視力、角膜刺激癥狀、角膜上皮愈合時間、角膜霧狀混濁(Haze)的發(fā)生情況、對比敏感度及立體視覺,以評價MMC在中度近視LASEK治療中的有效性及安全性。 方法:對19例36眼等效球鏡-3.00～-6.00D中度近視的患者進行LASEK矯正,病例隨機分成MMC組及對照組,其中MMC組激光切削后一次性使用體積分數(shù)為0.02%的MMC。觀察手術(shù)前常規(guī)指標及手術(shù)后裸眼視力、角膜刺激癥狀評分、角膜上皮愈合時間、角膜Haze發(fā)生眼數(shù)、對比敏感度函數(shù)(CSF)值及立體視銳度(SA)的變化。手術(shù)后隨訪6mo以上。 結(jié)果:隨著時間的推移,手術(shù)后兩組的視力逐漸恢復(fù),術(shù)后1mo、3mo、6mo,MMC組裸眼視力(UCVA)達到1.0眼數(shù)及百分比為12(63.16%)、15(78.95%)、19(100%),而對照組為11(64.71%)、14(82.35%)、17(100%)。手術(shù)后1w、2w、1mo、3mo、6mo兩組UCVA≥1.0的眼數(shù)比較無統(tǒng)計學差異,p0.05。除對照組出現(xiàn)1眼手術(shù)后角膜刺激癥狀評分為3分外,其余兩組術(shù)眼手術(shù)后得分均為1分及以下,手術(shù)后兩組角膜刺激癥狀評分比較無統(tǒng)計學差異,p0.05。除對照組有1眼角膜上皮為手術(shù)后2周愈合,其余術(shù)眼角膜上皮均在手術(shù)后7天內(nèi)愈合,手術(shù)后不同時間兩組角膜上皮愈合數(shù)無統(tǒng)計學差異,p0.05。兩組Haze發(fā)生數(shù)在手術(shù)后3個月時明顯增多,于6個月時趨于消退。手術(shù)后1mo、3mo、6mo,MMC組發(fā)生0.5級Haze的眼數(shù)為2、7、1,對照組為8、8、2,對應(yīng)P值分別為0.025、0.736、0.593,手術(shù)后1mo兩組發(fā)生0.5級Haze的眼數(shù)有統(tǒng)計學差異,p0.05,對照組0.5級Haze的發(fā)生率要高于MMC組。手術(shù)后兩組發(fā)生1級Haze眼數(shù)比較無統(tǒng)計學差異,p0.05。兩組CSF值在手術(shù)后1個月下降,3個月恢復(fù)手術(shù)前,組內(nèi)不同時間CSF值比較無統(tǒng)計學差異,p0.05。兩組手術(shù)前及術(shù)后不同時間的CSF值無統(tǒng)計學差異,p0.05。手術(shù)前、手術(shù)后1mo、3mo、6mo患者立體視銳度均≤60”(弧秒),手術(shù)后不同時間兩組立體視銳度≤60”(弧秒)的眼數(shù)無統(tǒng)計學差異,p0.05。 結(jié)論:LASEK矯正中度近視手術(shù)中使用0.02%MMC可以有效減輕患者手術(shù)后Haze的形成,不增加角膜刺激癥狀及不延長角膜上皮愈合時間。但手術(shù)后兩組在裸眼視力、對比敏感度、立體視覺方面無顯著性差異。
[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，

本文編號：1776155