Intraoperative Mitomycin and Corneal Endothelium After Photorefractive Keratectomy

Corneal endothelial cell injury induced by mitomycin-C in photorefractive keratectomy: Nonrandomized controlled trial

“…30,39,40 Morales et al 38 report higher endothelial cell loss after 3 months of follow-up in eyes that received intraoperative topical MMC 0.02% (0.2 mg/mL) for 30 minutes than in fellow eyes receiving BSS in a standard fashion (18.2% versus 5.0%). This contrasts with results reported by Carones et al 16 and Nassaralla et al, 44 who did not observe statistically significant postoperative differences in the ECC after application of a single dose of intraoperative MMC (0.2 mg/mL) for 2 minutes.…”

“…[21][22][23][24][25][26] Nevertheless, side effects, including corneal endothelial toxicity, have been reported after ophthalmic use and in in vitro experiments using MMC. [27][28][29][30][31][32][33][34][35][36][37][38][39][40] In addition, MMC may have long-term adverse effects as a radiomimetic agent. 31,32 Although the proposed side effects of MMC might be a drawback against its current relative popularity in the ophthalmic community, little is known about the extent of its effect after PRK.…”

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

“…To our knowledge, only 2 papers 18,19 were designed specifically to study the corneal endothelium in patients after laser surface ablation with intraoperative MMC application. Morales et al 18 compared a control group (9 eyes) that received no MMC and a study group (9 eyes) treated with intraoperative MMC 0.02% for 30 seconds, the same dose and time exposure we used in the current study.…”

“…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.…”

Re-Evaluation of the Safety of Laser-Assisted Subepithelial Keratectomy

“…Thus, some risk is inescapable with a LASEK procedure [8] [15] and, therefore, use of MMC might lead to widespread reduction in the incidence of this complication. Nevertheless, when applied to the cornea, MMC could potentially damage corneal epithelial [18] [19], stromal cells [20] [21], and endothelial cells [22] [23], so the possible toxicity of this drug remains a subject of intense debate [11].…”