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

Abstract

We present a case of dense, visually significant reticular haze that developed approximately 17 months after uneventful laser-assisted subepithelial keratectomy with mitomycin-C (MMC). The patient was successfully treated with manual debridement coupled with phototherapeutic keratectomy and intraoperative MMC.

Recurrent Corneal Hypertrophic Scar After Laser-Assisted Subepithelial Keratectomy With Mitomycin C Treatment

“…The response to topical corticosteroids and the relation with myopic regression were other points of differences. 18 One rare case of late-onset subepithelial corneal haze after LASEK with MMC was reported by Qazi et al 14 The clinical presentation and treatment were similar to what we describe in the present report. Our 2 patients also showed no risk factors such as a large treatment area, atopy, an autoimmune condition, highlevel UV exposure, or history of keloid.…”

Mitomycin-C in hyperopic photorefractive keratectomy

“…The varied quality of study designs and different time exposures in these reports do not allow a conclusive judgement. It must be remembered that late haze is possible, 21 that MMC has been detected in the anterior chamber after PRK, 22 and that alcohol sometimes used for deepithelialization has an additive effect with MMC in decreasing stromal keratocytes. 23 Cautious use of MMC is therefore advised; particular attention should be paid to concentration and time exposure and limiting the use of MMC to cases with higher refractive errors.…”

Very late-onset corneal scar triggered by trauma after photorefractive keratectomy

“…However, the use of MMC years earlier might not prevent late haze after trauma. [17][18][19] For example, Qazi et al 18 report a case of late dense haze 17 months after uncomplicated primary surface ablation with prophylactic MMC (0.02%) applied for 2 minutes. Teus et al 19 also report late corneal haze resulting from epithelial trauma 1 year after laser-assisted subepithelial keratectomy with intraoperative 0.02% MMC for 1 minute.…”