丝裂霉素c联合双氯芬酸钠在lasek术中的应用

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1、丝裂霉素C联合双氯芬酸钠在LASEK术中的应用【摘要】目的观察丝裂霉素C联合双氯芬酸钠滴眼液控制准分子激光上皮瓣下角膜磨镶术（LASEK）后角膜上皮下雾状混浊（Haze）、减轻术后疼痛及炎症反应的临床疗效。方法将中高度近视（－5.0～－10.0D）患者分为2组：实验组32例（64眼），分别于术前及术后2天滴0.1%双氯芬酸钠滴眼液，同时术中应用0.02%丝裂霉素C；将未应用双氯芬酸钠眼液和丝裂霉素C的32例（64眼）列为对照组。分别于术后1周内、1个月、3个月、6个月随访，1周内主要了解眼痛、畏光、流泪、异物感等症状及眼睑水肿和结膜充血情况，1个月后观察角膜Haz

2、e的发生、发展情况。结果实验组症状、体征综合评分于术后第1、3天明显低于对照组（P<0.01），第7天2组差异无显著性；实验组术后不同时期Haze发生程度均低于对照组（P<0.05）。结论丝裂霉素C联合双氯芬酸钠滴眼液对LASEK术后疼痛、炎症反应及Haze的形成具有明显的抑制作用。【关键词】准分子激光上皮瓣下角膜磨镶术；角膜上皮下雾状混浊；丝裂霉素C；双氯芬酸钠Abstract:ObjectiveToinvestigatetheclinicaleffectofapplyingmitomycin-Cincombinationwithdiclofenac

3、sodiumforpreventionagainstcornealsubepithelialhazeandtorelieve10painandinflammationsubsequenttolasersubepithelialkeratomileusis(LASEK).Methods64cases(128eyes)withmoderateandhighmyopia(-5.0to-10.0D)weredividedintotwogroups.32cases(64eyes)inexperimentalgroupweregiven0.1%diclofenacsodium

4、eyedropstwodaysbeforeandafterLASEKoperationrespectively,and0.02%mitomycin-Cduringtheoperation.Theother32cases(64eyes)thatdidnotreceivemitomycin-CanddiclofenacsodiumeyedropsthroughouttheLASEKprocessservedasthecontrolgroup.Follow-upwithin1week,1month,3monthsand6monthsafterLASEKoperation

5、wereconducted.The1stfollow-up(1week)wasfocusedontheassessmentsofeyepain,photophobia,lachrymation,foreignbodysensation,blepharoedemaandconjunctivalcongestion,whilethesubsequentfollow-ups(1month,3monthsand6monthsafterLASEKoperation)wereintendedtoobservethepossibleoccurrenceanddevelopmen

6、tofcornealhaze.ResultsThesymptomsoflocalirritationsandthedegreesofcornealhazeoccurrenceduringdifferentperiodsintheexperimentalgroupwereobviouslylowerthanthoseinthecontrolgroup(P<0.05).ConclusionMitomycin-Ccombinedwithdiclofenacsodiumhasobviousinhibitoryeffectsonpostoperativepain,in

7、flammatoryreactionsandtheformationofcornealhazesubsequenttoLASEK10operation.Keywords:lasersubepithelialkeratomileusis;cornealhaze;mitomycin-C;diclofenacsodium准分子激光上皮瓣下角膜磨镶术(LASEK)是一种介于准分子激光屈光性角膜切削(PRK)和准分子激光原位角膜磨镶术(LASIK)之间的屈光手术,因其兼顾PRK和LASIK的某些优点，同时避免了部分不足，近年来被广泛接受和应用。但是，术后角膜上皮下雾状混浊（

8、Haze）