Biological effects of mitomycin C on late corneal haze stromal fibrosis following PRK

Oliveira, Rodrigo Carlos de; Wilson, Steven E.

doi:10.1016/j.exer.2020.108218

Cited by 28 publications

(28 citation statements)

References 119 publications

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“…Common operations include: the principle of PRK surgery is that excimer laser is used to cut the central anterior corneal surface after corneal epithelium is scraped, that is, the anterior elastic layer and superficial stroma of the epithelium are removed to reduce the curvature of the anterior corneal surface, thus changing the refractive state of the operative eye [ 29 – 31 ]. Due to the destruction of corneal epithelium and anterior elastic layer during operation, the recovery of postoperative visual acuity was slower compared to LASIK, and the pain was obvious.…”

Section: Analysis and Discussionmentioning

confidence: 99%

Excimer Laser Corneal Refractive Surgery in the Clinic: A Systematic Review and Meta-analysis

Zhang¹,

Li²,

Cen³

2022

Computational and Mathematical Methods in Medicine

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Objective. To systematically evaluate the efficacy, safety, recovery speed, and long-term visual quality of excimer laser corneal refractive surgery and to provide evidence-based medicine for the promotion and use of excimer laser corneal refractive surgery. Methods. Randomized controls on excimer laser refractive surgery in Web of science, PubMed, EMBASE, ScienceDirect, Cochrane Library, China Knowledge Network (CNKI), China VIP Database, Wan Fang Database, and China Biomedical Literature Database (CBM) were searched by the computer. Randomized controlled trial (RCT) data were extracted independently by two researchers, and the risk of bias of each included RCT was assessed according to the Cochrane Handbook 5.1.0 criteria. Meta-analysis of the collected data was performed using RevMan5.4 statistical software. Results. In the end, 9 high-quality literatures were included, with a total of 4366 samples, and meta-analysis was used. There was no significant difference in uncorrected visual acuity WMD after excimer laser keratorefractive surgery, but there was a statistically significant difference in WMD in the safety of excimer laser keratorefractive surgery. The results of uncorrected visual acuity (close) indicated the following: Chi2 = 13.56, DF = 5, P = 0.02, and I2 = 100%; the results of uncorrected visual acuity (distance) indicated the following: Chi2 = 34.44, DF =5 (P < 00000), and I2 = 85%; the results of best corrected visual acuity (myopia) indicated the following: Chi2 = 0.65, DF = 3, P = 088 > 0.05, and I2 = 0%; the results of best corrected visual acuity (hyperopia) indicated the following: Chi2 = 1.80, DF = 3, P = 0.61 > 0.05, and I2 = 0%. Conclusion. Excimer laser corneal refractive surgery is safe and effective, with faster recovery and better long-term visual acuity treatment effect. However, more studies and follow-up with higher methodological quality and longer intervention time are needed for further validation.

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Section: Analysis and Discussionmentioning

confidence: 99%

Excimer Laser Corneal Refractive Surgery in the Clinic: A Systematic Review and Meta-analysis

Zhang¹,

Li²,

Cen³

2022

Computational and Mathematical Methods in Medicine

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“…In particular, although MMC augments keratocyte apoptosis in the anterior corneal stroma, it has been described to inhibit mitosis of myofibroblast precursor cells in ablation procedures such as PRK. 28 These can lead to a reduction haze formation as previously documented by Kanellopoulos et al 2 , 3 However, a significant increase in corneal haze incidence has been reported by Awwad et al 29 following MMC application in CXL procedure.…”

Section: Discussionmentioning

confidence: 83%

Combined photorefractive keratectomy and corneal collagen cross-linking for treatment of keratoconus: a 2-year follow-up study

et al. 2022

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Background: Corneal collagen cross-linking (CXL) is considered an effective procedure for slowing down or eliminating the progression of keratoconus. New techniques, in combination with CXL, have been proposed to stop the evolution of keratoconus and improve the visual function. Objective: To evaluate the effectiveness of combined photorefractive keratectomy (PRK) with mitomycin-C (MMC) application and CXL in the management of grade 1–2 keratoconus over a 2-year follow-up. Methods: Fifteen eyes underwent topography-guided PRK with 0.02% MMC application immediately followed by standard CXL. Results: Best corrected visual acuity improved from 0.15 ± 0.11 logMAR to 0.08 ± 0.09 logMAR at 24 months ( p < 0.0001) in treated eyes. Mean steepest meridian keratometry reduced from 48.79 ± 3.22 D at baseline to 46.16 ± 3.11 D at 24 months ( p < 0.0001). Mean flattest meridian keratometry reduced from 45.18 ± 2.17 D preoperatively to 44.35 ± 2.19 D at 24 months ( p < 0.0001). Conclusion: Simultaneous topography-guided PRK with MMC 0.02% application and standard CXL is a safe, promising and effective procedure in the treatment of mild and moderate keratoconus.

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“…According to a recent review, the most commonly used protocol, MMC 0.02% for 30 seconds after PRK, effectively decreased corneal fibrosis, especially in eyes with > 6 D of myopia, without significant long-term corneal or systemic side effects. 27 However, the reported MMC dosage varied among studies, and application time increased with the amount of myopic correction, up to a maximum duration of 2 min. 10 , 11 , 13 , 24 Hashemi et al reported that the use of 0.02% MMC for 10 sec per diopter of correction provided stable three-year visual outcomes with no complication for high myopia correction (> 6D).…”

Section: Discussionmentioning

confidence: 99%

Twelve-Month Outcomes of the Wavefront-Optimized Photorefractive Keratectomy for High Myopic Correction Compared with Low-to-Moderate Myopia

Tananuvat¹,

Winaikosol²,

Niparugs³

et al. 2021

OPTH

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Purpose: To evaluate the 12-months outcomes of photorefractive keratectomy (PRK) in patients with high myopia (≥ 6.0 diopters, D) compared with low-to-moderate myopia (< 6.0 D). Patients and Methods: Records of 46 patients (69 eyes) who underwent PRK for myopic and astigmatic correction between October 2015 and December 2018 were reviewed. High myopic eyes (29 eyes) were compared with low-to-moderate myopic eyes (40 eyes). All surgeries were adjunct with 0.02% mitomycin C intraoperatively. Measured outcomes included postoperative uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent, corneal haze rate, and any complications. Results: At 12 months post-PRK, 26 eyes (89.7%) in the high myopia and 39 eyes (97.5%) in the low-to-moderate myopia group had UDVA ≥ 20/20, (p=0.30). Average postoperative logMAR UDVA at 12 months was −0.04 (20/18) and −0.11 (20/15) for the high myopia and low-to-moderate myopia groups, respectively. No eyes in either group had residual refractive errors >1 D. No eyes in both groups developed significant corneal haze at month 12. No eyes had a loss of greater than two Snellen lines of CDVA at 12 months post-surgery. The efficacy and safety indices at 12 months post-surgery were not significantly different between groups (1.06±0.26 vs.1.14±0.27, p =0.25 and 1.14±0.27 vs 1.17±0.26, p=0.60 for low-to-moderate myopia vs high myopia groups, respectively). Conclusion: PRK with high myopic correction provides excellent refractive outcomes and is safe, compared to those of low-to-moderate myopic correction.

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Biological effects of mitomycin C on late corneal haze stromal fibrosis following PRK

Cited by 28 publications

References 119 publications

Excimer Laser Corneal Refractive Surgery in the Clinic: A Systematic Review and Meta-analysis

Excimer Laser Corneal Refractive Surgery in the Clinic: A Systematic Review and Meta-analysis

Combined photorefractive keratectomy and corneal collagen cross-linking for treatment of keratoconus: a 2-year follow-up study

Twelve-Month Outcomes of the Wavefront-Optimized Photorefractive Keratectomy for High Myopic Correction Compared with Low-to-Moderate Myopia

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