Comparison of laser epithelial keratomileusis with and without mitomycin C for wavefront customized surface ablations

To investigate the efficacy of mitomycin C (MMC) in preventing haze formation in surface wavefront customized ablations with successful refractive treatment (laser epithelial keratomileusis [LASEK]) and to evaluate the safety of this technique on corneal stroma and endothelium.

This study was a prospective, double-masked, randomized clinical trial involving 52 eyes (30 placebo and 22 MMC) of 26 patients. The manifest refractive spherical equivalent (MRSE), best spectacle-corrected visual acuity, uncorrected visual acuity, corneal pachymetry, topography, aberrometry, endothelial specular microscopy, contrast sensitivity, corneal confocal microscopy, and complaints of pain via a subjective questionnaire were recorded preoperatively and 90 days postoperatively.

The mean MRSE at 90 days postoperatively was -0.56 diopters (D) (-4.95 +/- 1.85 D, range: -8.00 to -1.62 D) for the MMC group and -0.49 D (-4.51 +/- 1.81 D, range: -7.75 to -2.25 D) for the placebo group. Higher order aberrations were similar between the placebo and MMC groups 90 days postoperatively (0.538 +/- 0.228 microm and 0.478 +/- 0.134 microm, respectively). Analysis of the endothelial cell count indicated a statistically significant decrease in endothelial cell density (P = .017) after LASEK, independent of MMC use.

The predictability of the final target refraction, induction of high order aberrations, and improvement in contrast sensitivity proved that the use of MMC was equally safe when compared to procedures that did not use MMC. In addition, the procedure was efficient in the prevention of corneal haze.