Long Term Followup of Photorefractive Keratectomy with Adjuvant Use of Mitomycin C

Abstract

Purpose. To study the long term refractive and visual outcomes of photorefractive keratectomy (PRK) with intraoperative application of mitomycin C (MMC). Methods. This study included 37 eyes who received myopic PRK; after photoablation, a sponge soaked in 0.02% MMC solution was applied in all corneas for 2 minutes. Efficacy, safety, predictability, and stability of PRK MMC were evaluated. Endothelial cell density was evaluated at the last postoperative interval. Results. Mean preoperative spherical equivalent (SEQ) was −6.03 ± 1.87 D (diopters) and reduced to −0.09 ± 0.53 D at the last postoperative examination. Mean followup was 44.73 ± 18.24 months. All the eyes were in the ±1.00 D of attempted versus achieved SEQ at the one-year follow-up interval. Furthermore, 95% of the eyes did not lose lines or gained 1 to 2 lines of CDVA, while 5% lost 1 line. At the third postoperative month, 89% of the eyes either were clear or had trace haze, while 4 eyes had mild haze; by the 12-month postoperative interval, none of the eyes demonstrated haze. Mean endothelial cell density (ECD) at the last postoperative interval was 2658 ± 153 cells/mm2. Conclusions. PRK, with intraoperative use of MMC, demonstrates stable refractive and visual outcomes up to 44 months after surgery.

The Results of Photorefractive Keratectomy in Myopia Correction after 5 Years

“…In a study conducted in 2013 by Vasilios F. Diakon is et al mean SE in average period of 44.73 months was reported as -0.27±0.70 D. 12 Also, in the study conducted by Marco Lombardo in 2010 mean spherical refractive error 8 years after surgery was reported as -0.11±0.50 D, 13 that is close to our study. In these two studies Mitomycin C was used, but in the study done by Vestgaard et al in 2013, mean SE13to 19 years after surgery was reported as -1.82±1.95 D. 3 In another study conducted by Norihiko Honda et al in 2004 mean SE 5 years after surgery was reported as -1.11±1.12 D. 14 The mean SE value in our study was lower than these two studies.…”

“… 3 In another study by Vasilios F. Diakonis et al in 2013 on the Allegretto laser platform 200hz using Mitomycin C, mean Log MAR UCVA 44 months after surgery was reported as 0.04±0.12 that is close to our study. 12 In this study meanLog MAR BCVA five year after operation was 0.008±0.044 and there was no significant difference in men and women groups as well as the age group less than & equal to25 years and more than 25 years and two groups with or without astigmatism before the operation.…”

Trabeculectomy bleb needling and antimetabolite administration practices in the UK: a glaucoma specialist national survey

“…Among those that did employ specific strategies, the majority used topical tetracaine, with the aim of precipitating the antimetabolites and preventing their effects on the cornea 8. Complacency among those who used no specific method to minimise the corneal effects may be due to the belief that a single dose is relatively harmless, especially given that topical MMC is used much more readily and intensively for conditions such as ocular surface squamous neoplasia18 and is also frequently used in photorefractive keratectomy 19. Standard practice at our institution is based on the principle that 5-FU is precipitated by tetracaine.…”

Corneal Haze Following Refractive Surgery

“…However, for the purpose of refractive surgery, endothelial cell counts seem to remain stable with no clinical or morphologic changes to the corneal subbasal nerve plexus, epithelium, and endothelium. 59,65,66 Given these potential deleterious ocular complications, application should be confined to the central cornea and dilutional errors should be rigorously avoided. The surface of the eye and fornices should be thoroughly irrigated following application.…”