Ascorbate prophylaxis with mitomycin-C for corneal haze after laser-assisted sub-epithelial keratectomy

Area of Science:

• Ophthalmology
• Corneal Surgery
• Laser Vision Correction

Background:

• Corneal haze is a common complication following photorefractive keratectomy (PRK) and laser-assisted subepithelial keratectomy (LASEK).
• Effective prevention strategies for post-LASEK haze are crucial for visual outcomes.

Purpose of the Study:

• To investigate the efficacy of oral ascorbic acid (vitamin C) supplementation combined with perioperative topical mitomycin-C for preventing corneal haze after LASEK.
• To determine if systemic ascorbate offers an additive benefit to standard topical mitomycin-C treatment.

Main Methods:

• A retrospective, non-randomized case series involving 96 myopic eyes undergoing LASEK.
• Patients were divided into two groups: one receiving oral ascorbic acid (500 mg twice daily) perioperatively, and a control group receiving no additional supplementation.
• Corneal haze was evaluated at the 1-year follow-up using a standardized scale (0-4).

Main Results:

• Corneal haze developed in 33.3% of the treatment group and 37.5% of the control group.
• The difference in haze incidence and severity between the ascorbic acid supplemented group and the control group did not reach statistical significance.
• Topical mitomycin-C alone demonstrated comparable efficacy to its combination with systemic ascorbate.

Conclusions:

• Systemic ascorbic acid supplementation does not provide an additional benefit in preventing corneal haze after LASEK when topical mitomycin-C is already administered.
• Topical mitomycin-C remains a key agent for haze prevention in LASEK procedures.
• Further research may explore alternative or adjunctive strategies for managing post-LASEK haze.