Systemic absorption of mitomycin-C when used in refractive surgery

Area of Science:

• Ophthalmology
• Pharmacology
• Surgical Research

Background:

• Mitomycin-C (MMC) is used in refractive surgery.
• Systemic absorption of MMC has been observed with larger doses.
• Concerns exist regarding potential systemic toxicity in refractive surgery patients.

Purpose of the Study:

• To investigate systemic absorption of mitomycin-C (MMC) after topical ocular application during refractive surgery.
• To determine if measurable plasma levels of MMC are present following standard refractive surgery procedures.

Main Methods:

• A case-control study involving 30 active-duty soldiers undergoing excimer laser photorefractive keratectomy with MMC.
• Blood samples were collected immediately after topical MMC application (0.2 mg/mL for 30 seconds).
• Plasma samples were analyzed using liquid chromatography mass spectrometry to detect MMC presence.

Main Results:

• Mitomycin-C (MMC) was not detected in any of the 30 plasma samples analyzed.
• The limit of quantification for MMC was 10.0 ng/mL.
• All samples were below the detectable limit, indicating no measurable systemic absorption.

Conclusions:

• Topical ocular application of MMC in refractive surgery does not lead to measurable systemic absorption.
• The findings suggest a negligible risk of systemic toxicity for patients undergoing refractive surgery with current MMC application methods.
• This study provides evidence to counsel patients on the extremely low likelihood of systemic absorption or toxicity.