化癌藥(Mitomycin-C)對高度近視患者首度施行雷射屈光角膜切除術的作用－病例報告

Abstract

Purpose: We present refractive outcome, refractive stability and the inhibition of subepithelial fibrosis after intraoperative soaking of mitomycin-C (0.02%) for primary photorefractive keratectomy in three patients who have high myopia. Method: All 6 eyes underwent PRK followed by intraoperative 2 minutes soaking of MMC and 30cc balanced salt solution irrigation, then covered with a bandage contact lens until epithelial healing was complete. The eyes received antibiotics (ofloxacin 0.3%), steroids (Fluoromethlone 0.1%) and artificial tears. Results: All eyes had no serious complication throughout the follow-up period (18 months). In case A & C, corneal hazes were all graded 0(defined by Fantes and colleagues); In case B, because the patient lost follow-up from the third week to the second months after operation, the right eye had haze grade 2, left eye had haze grade 3 in the peripheral area, and haze grade 0.5 in both center. After receiving strong steroid (Prednisolone acetate 1%), corneal haze regressed to grade 0 in center but no obvious change in the peripheral area. After 2 months, all bare VA were either 1.2 or 1.5, post-operatiove outcome of refraction was stable (0~-0.37 diopter) (In case B, VA and refraction were stable after 4 months). Conclusions: For high myopic (＞6D) patient who undergo PRK, intra-operative soaking of MMC (0.02%) may be a successful method for good refractive outcome and refractive stability, and inhibiting (or preventing) subepithelial fibrosis.