Photorefractive keratectomy with intraoperative mitomycin-C application

Abstract

Photorefractive keratectomy with intraoperative application of MMC was a safe procedure that produced excellent visual outcomes with few complications.

Development of late-onset subepithelial corneal haze after laser-assisted subepithelial keratectomy with prophylactic intraoperative mitomycin-C

“…A concentration-and duration-dependent effect on stromal keratocyte density has been shown in rabbit eyes following a single application of MMC, with greater MMC exposure affecting deeper stromal layers 45 and endothelium. 46 However, Lee et al 47 report no statistically significant decrease from preoperative level in endothelial cell densities measured by specular microscopy in 1011 human eyes following PRK with intraoperative MMC. To limit the potential risks of MMC exposure, they adjusted the exposure time of intraoperative MMC as a function of ablation depth and used an annular-shaped sponge for paracentral application of MMC, as originally described by Jain et al 48 Koch reserves repeat MMC for patients who developed haze during their initial surface ablation procedure, eyes with corneal surgery prior to the initial surface ablation, and enhancement procedure ablation depth greater than 20 mm Postoperative pharmacologic strategies to reduce the risk for post-LASEK haze involve the use of topical corticosteroids, nonsteroidals, and ascorbic acid, among others.…”

Creation of an extremely thin flap using IntraLase femtosecond laser

“…9,10 Although there are many reports that surface ablation with low dose mitomycin-C (MMC) can reduce postoperative haze in high myopia, the long-term safety of MMC has not been established. 11,12 Another choice was LASIK surgery with a microkeratome or IntraLase laser. The disadvantage of using a microkeratome (160 mm head; Hansatome [Bausch & Lomb] in our hospital) was that the remaining residual stromal thickness was less than 250 mm after full correction in this patient.…”

Effect of mitomycin-C on the corneal endothelium during excimer laser surface ablation

“…Torres et al 17 report a detectable concentration of MMC in the anterior chamber after topical application over the cornea, which suggests that the drug comes into contact with the deep stroma and the endothelium, raising the question of possible toxicity in these corneal layers. To our knowledge, only 2 papers 18,19 have reported the differences between endothelial cell counts in a group of patients before and after surface ablation with application of intraoperative MMC, with contradicting and not definitive results.…”