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Plasma rich in growth factors versus Mitomycin C in photorefractive keratectomy
Ronald M Sanchez-Avila1,2, Edmar E Uribe-Badillo1,3, Javier Fernández-Vega Sanz1
1Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo.
Abstract:
To evaluate the efficacy and safety of plasma rich in growth factors (PRGF) in photorefractive keratectomy (PRK) versus Mitomycin C (MMC).This is a comparative, longitudinal and retrospective case-control study (MMC vs PRGF), in patients with a spherical correction from -0.25 to -8.00 D and cylinder correction from -0.25 to -3.00. The uncorrected distance visual acuity (UDVA), refractive efficacy and safety indices, and changes in endothelial cell density were evaluated. The predictability was assessed with the postoperative manifest spherical equivalent.Forty-four patients (72 eyes) were treated with MMC and twenty-five patients (45 eyes) with PRGF. The final UDVA (LogMar) in MMC was 0.029 ± 0.065 and in PRGF it was 0.028 ± 0.048 (p = 0.383). The efficacy index for MMC was 0.98 ± 0.10 and 1.10 ± 0.46 for patients treated with PRGF (p = 0.062). The safety index for MMC was 1.03 ± 0.11 and 1.12 ± 0.46 (p = 0.158) for PRGF group. The change percentage of endothelial cell density was 0.9 ± 11.6 for MMC and 4.3 ± 13.1 for PRGF (p = 0.593). The predictability for MMC was 92.1% and for the PRGF was 91.9% (p = 0.976). Hyperemia, eye pain and superficial keratitis were observed in 11.1% of the MMC group; no adverse events were observed with the PRGF.The use of PRGF in PRK surgery is as effective as MMC. The PRGF shows a better safety profile than MMC for its intraoperative use in PRK.
Insights
Plasma rich in growth factors (PRGF) is as effective as Mitomycin C (MMC) for photorefractive keratectomy (PRK) surgery. PRGF demonstrates a superior safety profile, with no adverse events observed during intraoperative use in PRK.
Area of Science:
- Ophthalmology
- Regenerative Medicine
- Surgical Innovation
Background:
- Photorefractive keratectomy (PRK) is a common refractive surgery procedure.
- Mitomycin C (MMC) is frequently used during PRK to inhibit haze formation.
- Plasma rich in growth factors (PRGF) is explored as an alternative agent.
Purpose of the Study:
- To compare the efficacy and safety of PRGF versus MMC in PRK surgery.
- To evaluate visual acuity, refractive outcomes, and safety profiles.
- To assess predictability and endothelial cell density changes.
Main Methods:
- Comparative, longitudinal, retrospective case-control study.
- Patients with spherical corrections (-0.25 to -8.00 D) and cylinder corrections (-0.25 to -3.00) were included.
- Outcomes measured: Uncorrected Distance Visual Acuity (UDVA), refractive efficacy and safety indices, predictability, and endothelial cell density.
Main Results:
- No significant difference in final UDVA (LogMar) between MMC (0.029±0.065) and PRGF (0.028±0.048) groups (p=0.383).
- Efficacy index (MMC: 0.98±0.10 vs. PRGF: 1.10±0.46, p=0.062) and safety index (MMC: 1.03±0.11 vs. PRGF: 1.12±0.46, p=0.158) showed comparable trends.
- PRGF group had no observed adverse events, while the MMC group reported hyperemia, eye pain, and superficial keratitis in 11.1% of cases.
Conclusions:
- PRGF is a viable alternative to MMC in PRK surgery, offering comparable efficacy.
- PRGF exhibits a superior safety profile compared to MMC for intraoperative use in PRK.
- Further research may support PRGF as a preferred agent for enhanced patient safety in PRK.
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