Mitomycin Intravascular Chemoembolization for Corneal Neovascularization

The purpose of the study was to evaluate the efficacy of mitomycin C intravascular chemoembolization (MICE) for corneal neovascularization (CNV).

This is a prospective, nonrandomized, interventional study. Patients with stable CNV irrespective of the underlying etiology were enrolled in the study. 0.1% mitomycin C was injected intravascularly in CNV at the slit lamp under topical anesthesia. To evaluate the regression of vessels, the ImageJ software was used to trace and quantify vasculature by a pixel count in standardized clinical slit-lamp photographs.

Eight eyes from 8 patients with corneal neovascularization and lipid keratopathy were studied. The mean age at treatment was 37 ± 12.75 (range 17-64) years. The median follow-up was 419.5 days (74-1166 days). Herpes simplex keratitis was the main underlying etiology (75%). The visual axis was compromised in 75%, and 100% had stromal scarring. The mean pixel count before MICE was 5983.41 ± 5004.96 pixels. After the treatment, the mean pixel count was 2060.38 ± 3142.96 pixels (delta: 3923.03, P = 0.029). No complications were recorded during the follow-up period. No recurrence of the CNV was observed at the last follow-up. Two eyes (25%) underwent a successful keratoplasty 4 months after MICE.

MICE effectively reduced neovascularization with no immediate safety concerns, though its impact on vision and long-term safety requires further investigation with larger, longer term studies.