Hyperopic Photorefractive Keratectomy With Adjunctive Topical Mitomycin C for Refractive Error After Penetrating Keratoplasty for Keratoconus

Abstract

To our knowledge, this represents the first reported case of the use of MMC to prevent postoperative haze after PRK for PKP in an eye with keratoconus. MMC (0.02%) applied topically to the cornea immediately after PRK is safe and effective to treat a hyperopic refractive error after PKP and prevent postoperative corneal haze formation without the risks of performing a lamellar flap into an ectatic corneal bed.

Mitomycin-C in hyperopic photorefractive keratectomy

“…9 In a series of hyperopic PRK without MMC, 2 the mean haze grade was 0.64 at 12 months and there was significant undercorrection (mean SE 0.74 D); even so, a remarkable number of eyes had improved BSCVA. Other authors 1,4 also describe haze and undercorrection and report better results with laser in situ keratomileusis than with PRK without MMC.…”

“…[4][5][6][7][8] However, a Medline literature search of MMC use in hyperopic PRK using the key words photorefractive keratectomy, PRK, and mitomycin C (updated November 15, 2008) showed only a single case report 9 of PRK for keratoconus with a short follow-up. In the case report, C7.00 diopters (D) of hyperopia with À4.75 D astigmatism after keratoplasty was successfully treated by PRK with 0.02% MMC; there was no haze occurrence at 6 months.…”

Photorefractive keratectomy with mitomycin-C after corneal transplantation for keratoconus

“…25,26 The early results were variable and restricted by the development of the haze and regression commonly associated with significant corrections with all surface excimer laser procedures. [27][28][29] It is possible that the effect of haze was accentuated in these cases because of the presence of already activated keratocytes. 30 This problem, however, can be ameliorated, at least to some degree, by the use of postoperative mitomycin-C (MMC).…”

Mitomicina C e "Excimer laser"

“…Recentemente, descreveu-se o primeiro caso de PRK associado a MMC para correção de ametropia resisual pós-transplante penetrante de córnea em ceratocone (35) . Paciente apresentava refração de +7,00 DE -4,75 DC @ 125º dez meses após ceratoplastia penetrante, sem suturas corneanas.…”

“…Paciente apresentava refração de +7,00 DE -4,75 DC @ 125º dez meses após ceratoplastia penetrante, sem suturas corneanas. Foi submetido a PRK seguido da aplicação de MMC 0,02% com bom resultado (35) .…”