Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2021, Vol. 35 ›› Issue (6): 25-32.doi: 10.6040/j.issn.1673-3770.0.2021.363

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Corneal nerve fiber regeneration after SPT-TPRK combined with 0.02% MMC for moderate myopia: a random control study

YAN Chunxiao1,2, JIN Lin1,2, FANG Shifeng1, WEI Yushan3, WANG Lijing1, CUI Lin1, ZHAO Dan1, MU Yanan1,   

  1. ZHANG Lijun1, 21. Department of Ophthalmology, The Third People's Hospital of Dalian/ Dalian Eye Hospital, Dalian 116033, Liaoning, China;
    2. Dalian Medical University, Dalian 116044, Liaoning, China;
    3. The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning, China
  • Published:2021-12-10

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Abstract: Objective To observe the regeneration of nerve fibers in the corneal ablation area after transepithelial photorefractive keratectomy with smart pulse technology(SPT-TPRK)combination of 0.02% mitomycin C(MMC). Methods This random control study included 25 patients(50 eyes)with spherical equivalent(SE)from -3.00D to -6.00D. After SPT-TPRK, MMC was applied for 20 s in a concentration of 0.02% on one random eye(SPT-TPRK+MMC group)and no MMC on the other eye(SPT-TPRK group)for the contrl. All patients were observed by HRTⅢ confocal microscopy in order to compare CNFD and CNFL in peripheral and centeral corneal ablation area at preoperatively and 14 days,1month,and 3months postoperatively. Results Preoperatively, the CNFD in the central corneal zone was(52.40±12.61)nerves/mm2, and the CNFL was(73.00±12.61)mm/mm2. The neural changes in the central cornea ablation area are described below. Fourteen days after surgery, the CNFD and CNFL in the SPT-TPRK+MMC and SPT-TPRK groups were(13.41±4.99)nerves/mm2 and(5.73±3.27)nerves/mm2, and(17.44±7.30)mm/mm2 and(5.03±3.52)mm/mm2, respectively. The difference between the two groups was statistically significant(P<0.000 1). One month postoperatively, the CNFD and CNFL in the SPT-TPRK+MMC and SPT-TPRK groups were(20.57±5.43)nerves/mm2 and(8.46±5.07)nerves/mm2, and(27.57±8.97)mm/mm2 and(9.46±4.81)mm/mm2, respectively, with statistically significant differences between the two groups(P<0.000 1). Three months postoperatively, the CNFD in the SPT-TPRK+MMC and SPT-TPRK groups were(23.47±7.28)nerves/mm2 and(13.75±5.78)nerves/mm2, and(33.87±9.49)mm/mm2 and(17.00±5.90)mm/mm2, respectively, with statistically significant differences between the two groups(P<0.000 1). Conclusion SPT-TPRK combined with 0.02% MMC may promote nerve fiber regeneration in the early postoperative period(14 days, 1 month, 3 months). The nerve fibers have not returned to the preoperative situation at three months postoperatively.

Key words: Transepithelial photorefractive keratectomy with Smart Pulse Technology, Mitomycin C, Haze, Confocal microscopy, Nerve fibers

CLC Number: 

  • R779.63
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