Objective To compare the postoperative efficacy and complications of using an intraoperative application of either mitomycin (MMC) or a chilled balanced salt solution (CBSS) during epipolis laser in situ keratomileusis (Epi-LASIK). Methods Forty patients (80 eyes) who underwent Epi-LASIK from May to December 2013 in our center were randomly divided into two groups of 20 patients (40 eyes) each based on MMC or CBSS treatment. In the MMC group, a sponge with 0.02% MMC was used after laser ablation to cover the corneal stromal bed for 20 s and then rinsed with a 20 ml balanced salt solution at normal temperature; in the CBSS group, 10 ml 4 ℃ of a balanced salt solution was used to flush the stromal bed after laser ablation. Patients′ preoperative uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), IOP, UCVA, corneal haze, intraocular pressure, residual refractive error were recorded preoperatively and postoperatively at 6 months. Data were analyzed using a t test, repeated measures ANOVA, and a chi-square test. Results The surgery was successfully completed on all patients. The epithelial healing time for the MMC group was 4-6 d (average 4.2±0.1 d), and was 4-13 d (average 4.5±0.3 d) for the CBSS group. There was no statistically significant difference between the groups. UCVA at 1 month was not significantly different between the two groups but the differences at 2, 3, 4 and 6 months were significant (F=17.503, P<0.01). The differences in average IOP at 1, 2, 3, 4 and 6 months were not statistically significant. The residual refractive error (SE) in the MMC group was +0.43±0.06 D, and was +0.35±0.09 D in the CBSS group. The difference was statistically significant (t=2.680, P<0.05). Conclusion There were no significant differences postoperatively when epithelial healing, corneal haze, curative efficacy, IOP and residual refractive error were compared between patients treated intraoperatively with applications of MMC or CBSS. The UCVA of patients treated with CBSS is slightly better than for MMC.
沈政伟,刘颖,姜黎. 术中应用丝裂霉素与低温平衡盐溶液对Epi-LASIK术后疗效的影响[J]. 中华眼视光学与视觉科学杂志, 2015, 17(12): 726-729.
Shen Zhengwei,Liu Ying,Jiang Li. The postoperative impact of mitomycin and a chilled balanced salt solution during Epi-LASIK surgery. Chinese Journal of Optometry Ophthalmology and Visual science, 2015, 17(12): 726-729. DOI: 10.3760/cma.j.issn.1674-845X.2015.12.006
Chen SH, Feng YF, Stojanovic A, et al. Meta-analysis of clinical outcomes comparing surface ablation for correction of myopia with and without 0.02% mitomycin C[J]. J Refract Surg,2011, 27(7):530-541.
Carones F, Vigo L, Scandola E, et al. Evaluation of the prophylactic use of mitomycin-C to inhibit haze formation after photorefractive keratectomy[J]. J Cataract Refract Surg,2002,28(12):2088-2095.
Baz O, Kara N, Bozkurt E, et al. Photorefractive keratectomy in the correction of astigmatism using Schwind Amaris 750 s laser[J]. Int J Ophthalmol,2013,6(3):356-361.