Laser epithelial keratomileusis with mitomycin C: indications and limits

Area of Science:

• Ophthalmology
• Corneal Surgery
• Refractive Surgery

Background:

• Laser epithelial keratomileusis (LASEK) is a refractive surgery procedure.
• Mitomycin C (MMC) is sometimes used during LASEK to inhibit fibroblast proliferation and reduce haze.
• The impact of MMC on corneal aberrations and refractive predictability requires further investigation.

Purpose of the Study:

• To evaluate the efficacy and safety of using mitomycin C (MMC) during laser epithelial keratomileusis (LASEK).
• To assess the influence of MMC on high-order aberrations and refractive outcomes after LASEK.

Main Methods:

• A comparative study involving 86 eyes treated with LASEK and MMC (0.01%) and 100 eyes treated with LASEK alone (control group).
• Corneal refractive error, best spectacle-corrected visual acuity (BSCVA), haze, and high-order aberrations were measured preoperatively and at 1 month and 1 year postoperatively.
• Follow-up periods were 312 days for the MMC group and 774 days for the control group.

Main Results:

• The MMC group showed significantly reduced subepithelial haze compared to the control group (P<.05).
• Refractive outcomes were less predictable in the MMC group, with noted early and late overcorrections.
• Increased high-order aberrations were observed at 1 month and 1 year in eyes treated with MMC.

Conclusions:

• Mitomycin C (0.01%) effectively reduces haze after LASEK but compromises refractive predictability.
• The use of MMC in LASEK is associated with an increase in high-order aberrations.
• Further studies are required to establish optimal MMC concentrations and exposure times for LASEK.