Mitomycin C in corneal refractive surgery.

Area of Science:

• Ophthalmology
• Corneal Surgery
• Pharmacology

Background:

• Excimer laser surface ablation is a key refractive surgery technique.
• Postoperative corneal haze is a significant complication.
• Mitomycin C is utilized to mitigate this risk.

Purpose of the Study:

• Review the mechanism of action, histological effects, and clinical use of Mitomycin C.
• Evaluate its efficacy and safety in corneal refractive surgery.
• Summarize optimal dosage and application parameters.

Main Methods:

• Literature review of studies on Mitomycin C in corneal refractive surgery.
• Analysis of its mechanism, effects on corneal layers, and clinical outcomes.
• Evaluation of reported concentrations, exposure times, and toxicity.

Main Results:

• Mitomycin C, an alkylating agent, reduces myofibroblast repopulation, thus decreasing corneal haze risk.
• It is used both prophylactically and therapeutically for corneal haze.
• Standard application is 0.2mg/ml for 12-120 seconds; lower concentrations may suffice for low myopia.
• No significant epithelial toxicity observed; endothelial effects are debated, and keratocyte depletion appears temporary.

Conclusions:

• Mitomycin C is crucial in modern laser corneal ablation, effectively preventing and treating haze.
• Optimal prophylactic use guidelines are still evolving, particularly regarding specific ablation depths or refractive error.
• Current evidence suggests a favorable safety profile, though long-term endothelial and keratocyte effects warrant continued monitoring.