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Effect of mitomycin-C on the variance in refractive outcomes after photorefractive keratectomy
Mary Ellen Sy1, Lijun Zhang1, Allen Yeroushalmi1
1From the American Eye Center (Sy), Makati, Manila, Philippines; the Refractive Center (Zhang), the 3rd Hospital of Dalian, Dalian, China; Weill Cornell Medical College (Yeroushalmi), New York, New York, and California Pacific Medical Center (Huang), San Francisco, and UCLA Laser Refractive Center (Hamilton), Jules Stein Eye Institute, David Geffen School of Medicine at University of California, Los Angeles, California, USA.
Purpose:
To compare the variance in manifest refraction spherical equivalent (MRSE) after photorefractive keratectomy (PRK) with mitomycin-C (MMC), PRK without MMC, and laser in situ keratomileusis (LASIK) for the treatment of myopic astigmatism.
Setting:
Jules Stein Eye Institute, University of California, Los Angeles, Los Angeles, California, USA.
Design:
Retrospective case series.
Methods:
Patients were classified into 3 groups of preoperative refraction-matched eyes as follows: PRK with MMC 0.02%, PRK without MMC, and LASIK. The preoperative and postoperative MRSE, preoperative corrected distance visual acuity, and postoperative uncorrected distance visual acuity (UDVA) were analyzed.
Results:
Each group comprised 30 eyes. Follow-up was at least 6 months in the LASIK group and 12 months in the 2 PRK groups. There were no statistically significant differences in the mean preoperative MRSE (P=.95) or postoperative MRSE (P=.06) between the 3 groups. The mean postoperative MRSE was -0.07 diopter (D) ± 0.47 (SD), -0.14 ± 0.26 D, and 0.02 ± 0.25 D in the PRK with MMC 0.02% group, PRK without MMC group, and LASIK group, respectively. The variance in the postoperative MRSE in the PRK with MMC 0.02% group was significantly higher than that in the PRK without MMC group (P=.002) and in the LASIK group (P=.001). There was no statistically significant difference in the mean postoperative UDVA between the 3 groups (P=.47).
Conclusions:
Refractive outcomes after PRK for myopia were more variable when MMC 0.02% was used. This should be weighed against the advantage of intraoperative MMC use in reducing haze after PRK.
