Effect of intraoperative mitomycin-C on healthy corneal endothelium after laser-assisted subepithelial keratectomy

Zhao, Li-Quan; Wei, Rui; Ma, Xin; Zhu, Huang

doi:10.1016/j.jcrs.2008.06.016

Cited by 29 publications

(26 citation statements)

References 20 publications

(20 reference statements)

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“…However, studies in patients undergoing refractive surgery have generally not shown harm 10–12. In this case series, the available endothelial cell counts failed to show any decrease in the DSEK graft from the use of mitomycin C, although this involved only a small number of patients and the variability of specular microscopy seemed significant, given that it is unlikely a patient truly increased their endothelial cell count by 1,344 cells/mm 2 post-PTK.…”

Section: Discussionmentioning

confidence: 57%

Visual and subjective outcomes of phototherapeutic keratectomy after Descemet’s stripping endothelial keratoplasty

Lee

Hardten

2014

OPTH

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BackgroundPatients with endothelial disease also often have scarring or surface corneal disease. This study examined the outcomes of phototherapeutic keratectomy (PTK) performed in patients with prior Descemet’s stripping endothelial keratoplasty (DSEK).MethodsThis retrospective case series examined all patients undergoing PTK after DSEK in a single private practice. The primary outcome was best-corrected visual acuity, with secondary outcomes of change in spherical equivalent versus targeted change, change in endothelial cell count, improvement in corneal topography, and subjective satisfaction with vision.ResultsFor the ten patients who met the inclusion criteria, mean best-corrected visual acuity improved from logarithm of the minimum angle of resolution (logMAR) 0.43 to 0.36 (P=0.24) at the most recent postoperative visit. PTK treatments that included a refractive component showed good predictability of 1.13 diopters spherical equivalent/diopter attempted. There was no evidence of a decrease in endothelial cell count from PTK, even with the use of mitomycin C (P=0.95). Subjectively, 80% of patients noted improvement in their vision.ConclusionPTK after DSEK has the potential to improve patients’ vision with high levels of patient satisfaction, even though many patients had significant ocular comorbidities. Surgeons should consider using PTK to treat anterior corneal pathology following DSEK.

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Section: Discussionmentioning

confidence: 57%

Visual and subjective outcomes of phototherapeutic keratectomy after Descemet’s stripping endothelial keratoplasty

Lee

Hardten

2014

OPTH

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“…60,61 Although a growing number of studies confirm the judicious use of MMC as safe in terms of possible complications, they must be taken into account when weighing the relative merits of PRK against those of other techniques. [62][63][64][65][66] Barreto et al 67 recently described positive results in a case of a topography-guided ablation with MMC after PKP for keratoconus. The ability to correct irregular astigmatism is a limiting factor in achieving the best results in the post-PKP eye.…”

Section: Discussionmentioning

confidence: 98%

Photorefractive keratectomy with mitomycin-C after corneal transplantation for keratoconus

Hodge

Sutton

Lawless

et al. 2011

Journal of Cataract and Refractive Surgery

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“…Zhao et al, [8] , evaluated the effect of (MMC) on corneal endothelial cells after Laser-Assisted Sub-Epithelial Keratectomy (LASEK). One hundred seventy-four eyes of 89 patients who did not previously wear contact lenses were treated with LASEK with intraoperative use of topical MMC 0.02% (15 seconds).…”

Section: Discussionmentioning

confidence: 99%

Corneal Endothelial Cell Changes after Photorefractive Keratectomy for Low to Moderate Myopia With and Without Mitomycin-C

Hasby¹,

Seliema

2019

The Medical Journal of Cairo University

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Background: Mitomycin-C was suggested for application during surface ablation procedures to reduce post-operative haze formation. It can effectively reduce haze formation and hence, improve the predictability of visual outcomes following refractive surgery. Despite these advantages, MMC can potentially damage all three main corneal cell types including epithelial (differentiated epithelium and limbal cells), stromal (keratocytes), and endothelial cells. Aim of Study:To investigate the croneal endothelial cell changes after Photorefractive Keratectomy (PRK) with and without Mitomycin-C 0.02% for low to moderate myopia. Patient and Methods:This prospective, randomized, comparative study included 60 eyes of 30 patients who were chosen from Ophthalmology Clinic at Tanta University Hospital and Shorouk Laser Vision Correction Centre for 6 month from December 2017 to May 2018 and scheduled for Photorefractive Keratectomy (PRK) using193nm wavelength excimer laser system Allegretto EX500, (Wave Light Technologie., USA). These patients were randomly divided into two groups. Group (A) were scheduled for (PRK) with adjunctive mitomycin-C 0.02% and patients of Group (B) were scheduled for (PRK) without mitomycin-C. Informed consents were obtained from all study participants.Results: In Group A the mean Endothelial Cell Density (ECD) was 2891.61 ± 272.41 and at three months after surgery was 28 13.04±276.55cells/mm 2 (p=0.289), pre-operative mean of Coefficient of Variation (CV) was 34.87 ± 4.37 and postoperatively was 34.70 ±4.06 (p=0.877), the pre-operative mean of Central Corneal Thickness (CCT) was 523.00 ±26.14 µ and 467.36 ± 40.61 µ post-operatively (p=0.001), the mean of hexagonality pre-operatively was 64.26 ±8.64% and 59.96 ± 8.15% post-operatively (p=0.059) which was statistically insignificant. In Group B the mean Endothelial Cell Density was (ECD) 2874.50±314.48 and at three months after surgery was 2777.23±302.44cells/mm 2 (p=0.227), pre-operative mean of Coefficient of Variation (CV) was 33.49 ± 4.98 and postoperatively 33.55 ± 4.10 (p=0.962), pre-operative mean of central corneal thickness was 538.03 ± 26.03 and 484.50 ± 20.55 post-operatively (p=0.001), the mean of hexagonality preoperatively was 63.00±7.74 and 61.43±7.29% post-operatively (p=0.423). Conclusions:There's no significant effect on endothelium in patients underwent to PRK in low to moderate myopia with or without mitomycin-C. We can't judge the same results for patients with high myopia because the ablation depth will be more and theoretically the diffusion of mitomycin-C to endothelium would affect its function or count.

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Effect of intraoperative mitomycin-C on healthy corneal endothelium after laser-assisted subepithelial keratectomy

Abstract: The use of intraoperative topical MMC 0.02% for 15 seconds after LASEK did not affect the corneal endothelium.

Cited by 29 publications

References 20 publications

Visual and subjective outcomes of phototherapeutic keratectomy after Descemet’s stripping endothelial keratoplasty

Visual and subjective outcomes of phototherapeutic keratectomy after Descemet’s stripping endothelial keratoplasty

Photorefractive keratectomy with mitomycin-C after corneal transplantation for keratoconus

Corneal Endothelial Cell Changes after Photorefractive Keratectomy for Low to Moderate Myopia With and Without Mitomycin-C

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Effect of intraoperative mitomycin-C on healthy corneal endothelium after laser-assisted subepithelial keratectomy

Abstract: The use of intraoperative topical MMC 0.02% for 15 seconds after LASEK did not affect the corneal endothelium.

Cited by 29 publications

References 20 publications

Visual and subjective outcomes of phototherapeutic keratectomy after Descemet&rsquo;s stripping endothelial keratoplasty

Visual and subjective outcomes of phototherapeutic keratectomy after Descemet&rsquo;s stripping endothelial keratoplasty

Photorefractive keratectomy with mitomycin-C after corneal transplantation for keratoconus

Corneal Endothelial Cell Changes after Photorefractive Keratectomy for Low to Moderate Myopia With and Without Mitomycin-C

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Visual and subjective outcomes of phototherapeutic keratectomy after Descemet’s stripping endothelial keratoplasty

Visual and subjective outcomes of phototherapeutic keratectomy after Descemet’s stripping endothelial keratoplasty