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Keratocyte density 3 months, 15 months, and 3 years after corneal surface ablation with mitomycin C
Laura de Benito-Llopis1, Pilar Cañadas, Pilar Drake
1Vissum Madrid, Madrid, Spain. lbenito@vissum.com
Purpose:
To study the effects of surface ablation with mitomycin C (MMC) on keratocyte population.
Design:
Prospective, nonrandomized, interventional, comparative case series.
Methods:
Thirty two eyes treated with surface ablation with 0.02% MMC were compared with nontreated eyes at Vissum Santa Hortensia, Madrid, Spain. Keratocyte density was measured with the Heidelberg Retina Tomograph II (Rostock Cornea Module) 3, 15, and 36 to 42 months after the surgery in the anterior, mid, and posterior stroma, and compared with control eyes.
Results:
Three months postoperatively, we found a lower stromal bed density compared to controls (16 993 ± 8001 vs 29 660 ± 5904 cells/mm(3), P = .0001), while there was a significantly higher cell density in the mid (30 783 ± 9300 vs 18 505 ± 1996 cells/mm(3), P = .0001) and deep stroma (30 268 ± 8321 vs 18 438 ± 2139 cells/mm(3), P = .0001). Three years after the surgery, the cellularity in the stromal bed had not significantly changed from the 3-month follow-up, but the density in the mid (18 889 ± 3474 cells/mm(3)) and posterior stroma (18 992 ± 3402 cells/mm(3)) had decreased to show no difference from controls. The mean cell density between the anterior, mid, and posterior stroma was not significantly different from controls 15 months and 3 years after the surgery.
Conclusion:
Our study suggests that there is a reorganization of the stromal cell population soon after surface ablation with MMC, with a decrease in the stromal bed compensated initially with an increase in the mid and posterior stroma. Corneal cellularity tends to normalize over time, and 3 years postoperatively the mean cell density throughout the cornea seems to maintain normal values.
Insights
Surface ablation with mitomycin C (MMC) initially decreases stromal bed keratocyte density, but cell populations reorganize and corneal cellularity normalizes within three years post-surgery.
Area of Science:
- Ophthalmology
- Corneal Surgery
- Cell Biology
Background:
- Surface ablation is a common refractive surgical technique.
- Mitomycin C (MMC) is used to inhibit fibroblast proliferation and prevent haze.
- The effect of MMC on corneal keratocyte populations requires further investigation.
Purpose of the Study:
- To evaluate the impact of surface ablation with MMC on keratocyte density in the cornea.
- To analyze changes in keratocyte populations at different stromal depths over time.
Main Methods:
- A prospective, nonrandomized, interventional study comparing 32 eyes treated with surface ablation and MMC to control eyes.
- Keratocyte density was measured using the Heidelberg Retina Tomograph II (Rostock Cornea Module) at 3, 15, and 36-42 months post-surgery.
- Measurements were taken in the anterior, mid, and posterior stroma.
Main Results:
- Three months post-surgery, stromal bed density was significantly lower, while mid and deep stromal densities were significantly higher compared to controls.
- At three years, stromal bed cellularity remained unchanged, and mid and posterior stromal densities decreased to control levels.
- Mean cell density across all stromal layers was not significantly different from controls at 15 months and 3 years post-surgery.
Conclusions:
- Surface ablation with MMC induces an initial reorganization of corneal keratocyte populations.
- Corneal cellularity demonstrates a trend towards normalization over time.
- Long-term follow-up suggests that mean corneal cell density returns to normal levels by three years post-procedure.
