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Mitomycin C in photorefractive keratectomy.

Ashraf Shalaby¹, Geoffrey B Kaye, Howard V Gimbel

¹Gimbel Eye Centre, Edmonton, Alberta, Canada.

Journal of Refractive Surgery (Thorofare, N.J. : 1995)

|March 3, 2009

Summary

Mitomycin C (MMC) 0.02% effectively prevented haze after photorefractive keratectomy (PRK) and phototherapeutic keratectomy (PTK). This prophylactic treatment was successful in eyes with high myopia, previous radial keratotomy (RK), or corneal scarring.

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Area of Science:

Ophthalmology
Corneal Surgery
Refractive Surgery

Background:

Haze and regression are common complications following photorefractive keratectomy (PRK) and phototherapeutic keratectomy (PTK).
Previous radial keratotomy (RK), high myopia, and corneal scarring increase the risk of these complications.
Prophylactic use of mitomycin C (MMC) may mitigate haze formation.

Purpose of the Study:

To evaluate the efficacy of prophylactic intraoperative mitomycin C (MMC) 0.02% in preventing haze and regression after PRK or PTK.
To assess MMC's effectiveness in specific high-risk patient groups, including those with prior RK, high myopia, or corneal scarring.

Main Methods:

Retrospective analysis of 34 eyes undergoing PRK or PTK with intraoperative MMC.
MMC 0.02% applied immediately after laser ablation.

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Postoperative follow-up included examinations at 3, 7 days, and monthly for 6 months, with haze grading and visual acuity assessment.

Main Results:

At 6-month follow-up, 56% of eyes had grade 0+ haze and 44% had trace haze (0.5+).
Postoperative visual acuity outcomes were favorable, with a significant number of eyes achieving uncorrected visual acuity (UCVA) of 20/20 or better.
No significant recurrent haze was observed in the treated eyes.

Conclusions:

Prophylactic intraoperative mitomycin C (MMC) 0.02% is effective in preventing significant haze after PRK and PTK.
MMC demonstrates efficacy in high-risk eyes, including those with high myopia, previous RK, or corneal scarring.
The use of MMC during refractive surgery can lead to clear corneas and good visual outcomes.