Related Experiment Video
Updated: Jul 20, 2026
An “All-laser” Endothelial Transplant
Published on: July 6, 2015
Intraoperative mitomycin and corneal endothelium after photorefractive keratectomy
Alberto J Morales1, David Zadok, Rolando Mora-Retana
1Codet-Aris Vision Institute, Tijuana, Mexico.
Purpose:
To determine whether there is an increased risk to the corneal endothelium when mitomycin C (MMC) is administered after photorefractive keratectomy (PRK).
Design:
Prospective, randomized, double-blind, placebo-controlled crossover trial.
Methods:
Corneal endothelium was analyzed preoperatively and postoperatively in 18 eyes of nine patients who were administered either MMC- or balanced salt solution (BSS)-supplemented PRK at Codet Aris Vision, Tijuana, Mexico. After laser ablation, one eye was randomly assigned to intraoperative topical MMC 0.02% treatment for 30 seconds, and the fellow eye (the control eye) was treated in a standard fashion with topical BSS. Preoperative pachymetry and endothelial cell count were performed and compared with postoperative measurements after one month and three months. Main outcome measure studied was endothelial cell loss.
Results:
There was no significant difference in the preoperative endothelial cell count between the 2 groups: MMC group 2835 +/- 395, control group 2779 +/- 492, P = .62. In the control group, at one month and three months the difference in the endothelial cell count was not statistically significant (P = .27, P = .14, respectively). However, in the MMC group the endothelial cell loss was statistically significant: at one month 14.7 +/- 5.1%, and at three months 18.2 +/- 9.0% (P = .0006, P = .002, respectively).
Conclusions:
The use of intraoperative topical MMC 0.02% for 30 seconds after PRK may affect the endothelial cell count.
Insights
Intraoperative topical mitomycin C (MMC) after photorefractive keratectomy (PRK) significantly increased endothelial cell loss. This study suggests a potential risk to corneal endothelium following MMC use in PRK procedures.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Ophthalmic Pharmacology
Background:
- Photorefractive keratectomy (PRK) is a common refractive surgery.
- Mitomycin C (MMC) is sometimes used during PRK to inhibit haze formation.
- Potential risks of MMC to the corneal endothelium require investigation.
Purpose of the Study:
- To assess the risk of corneal endothelial cell loss when mitomycin C (MMC) is applied after photorefractive keratectomy (PRK).
Main Methods:
- A prospective, randomized, double-blind, placebo-controlled crossover trial.
- 18 eyes of 9 patients undergoing PRK were analyzed.
- One eye received topical MMC 0.02% for 30 seconds, while the fellow eye received balanced salt solution (BSS) as a control.
Main Results:
- No significant difference in preoperative endothelial cell count was observed between MMC and control groups.
- The control group showed no statistically significant endothelial cell loss at one or three months.
- The MMC group exhibited statistically significant endothelial cell loss of 14.7% at one month and 18.2% at three months.
Conclusions:
- Intraoperative topical MMC 0.02% applied for 30 seconds after PRK may lead to significant corneal endothelial cell loss.
- This finding indicates a potential adverse effect of MMC on the corneal endothelium in PRK patients.
