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Updated: Dec 8, 2025
Author Spotlight: Advancing Corneal Innervation Research Through Innovative Models
Published on: December 8, 2023
Effect of intraoperative mitomycin-C application on epithelial regeneration after transepithelial photorefractive
Nan-Ji Lu1, Carina Koppen, Shady Awwad
1From the School of Medicine and Health Sciences, University of Antwerp (Lu, Koppen), Wilrijk, Belgium; School of Ophthalmology and Optometry, Wenzhou Medical University (Lu, I. Aslanides, Chen), Wenzhou, Zhejiang, China; Emmetropia Mediterranean Eye Institute (M. Aslanides, I. Aslanides) Heraklion, Greece; The American University of Beirut Medical Center, Cairo Street (Awwad), Beirut, Lebanon.
Purpose:
To investigate the effect of mitomycin-C (MMC) intraoperative application on postoperative corneal epithelial remodeling, haze incidence, and refractive correction in transepithelial photorefractive keratectomy (transPRK).
Setting:
Eye Hospital of Wenzhou Medical University, Wenzhou, China.
Design:
Prospective randomized controlled study.
Methods:
Eyes that completed all follow-ups were included. Epithelial thickness (ET) map measurement was conducted preoperatively and at 1 week, and at 1 month, 3 months, and 6 months postoperatively, generating ET in central, paracentral, and midperipheral zones. The difference between postoperative and preoperative ET (ΔET) was computed for each zone. During follow-up, haze incidence and visual acuity were assessed and compared between groups.
Results:
A total of 100 eyes completed all follow-up, including 40 eyes treated with MMC in MMC group and 60 eyes in control group without MMC treatment. For ΔET, between-group difference was found in midperipheral (P = .011) zone at 1 week postoperatively and in central (P = .036) and paracentral zones (P = .039) at 1 month postoperatively. Haze incidence was lower in MMC group at 1 week and 1 month postoperatively (P = .035 and .018, respectively). Safety index (postoperative uncorrected distance visual acuity/preoperative corrected distance visual acuity [CDVA]) and efficacy index (postoperative CDVA/preoperative CDVA) were higher in MMC group (P = .012 and P = .036, respectively) at 1 month postoperatively. No difference was found after 3 months postoperatively.
Conclusions:
With a temporary impact on corneal epithelial regeneration and refractive correction, intraoperative MMC application in transPRK decreased the haze incidence but had no effect on epithelial remodeling.
