Mitomycin C–Assisted Photorefractive Keratectomy in High Myopia: A Long-term Safety Study

Gambato, Catia; Miotto, Stefania; Cortese, Marta; Ghirlando, A.; Lazzarini, Daniela; Midena, Edoardo

doi:10.1097/ico.0b013e31820123c8

Cited by 37 publications

(54 citation statements)

References 35 publications

(47 reference statements)

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“…12 The decrease in the efficacy to o1 in our study was due to one patient with BCVA decrease of 1 line in the end of the first year when compared with that before the operation.…”

Section: Discussionmentioning

confidence: 97%

“…7 On the other hand, PRK might result in corneal haze, although its incidence has decreased recently with the application of modern lasers and mitomycin. 11,12,14 Another important point is that we only evaluated the results of the first year post operation.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 Recent studies have indicated that mitomycin C (MMC) can decrease the incidence and severity of corneal haze, resulting in an acceptable visual acuity and quality. [11][12][13][14] A meta-analysis of 85 published articles compared PIOL and LASIK, 7 and the comparative results of PIOL and PRK in mild and moderate myopia have been already reported. 6,15 Therefore, considering the increased safety of PRK-MMC, we decided to compare PRK-MMC and PIOL in correcting high myopia.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of the visual outcomes between PRK-MMC and phakic IOL implantation in high myopic patients

Hashemi

Miraftab

Asgari

2014

Eye

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Purpose To compare the visual outcomes between PRK-MMC and phakic IOL in patients with more than 8 diopter (D) of myopia. Methods This comparative study was performed on 23 eyes under treatment with Artiflex (group A) and 23 eyes under treatment with PRK-MMC (group B). Artiflex phakic IOL (Ophtec BV) was used in group A, and the VISX STAR S4 Excimer Laser (Abbott) was used for PRK-MMC in group B. Results The safety index was 1.11 ± 0.23 and 1.05 ± 0.25 (P ¼ 0.100) and the efficacy index was 1.02 ± 0.11 and 0.98 ± 0.10 (P ¼ 0.266) in group A and B, respectively. At 1 year after surgery, the manifest refraction spherical equivalent was À 0.17±1.18 and À 0.25±0.18 D in group A and B, respectively (P ¼ 0.471). Mesopic CS showed no significant difference between the two groups in any spatial frequency. Total coma was 0.24 ± 0.17 and 0.67 ± 0.40 mm (Po0.001), spherical aberration was À 0.11±0.11 and 0.41±0.18 mm (Po0.001), and RMS HOA T was 0.50±0.20 and 0.96±0.45 mm (Po0.001) in group A and B, respectively. Conclusion Phakic IOL implantation was better than PRK-MMC in the correction of high myopia in terms of visual quality, but the two methods had no difference with regard to visual acuity. Therefore, PRK-MMC can be used when the anterior chamber depth is a limiting factor in the implantation of phakic IOLs.

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“…12 The decrease in the efficacy to o1 in our study was due to one patient with BCVA decrease of 1 line in the end of the first year when compared with that before the operation.…”

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of the visual outcomes between PRK-MMC and phakic IOL implantation in high myopic patients

Hashemi

Miraftab

Asgari

2014

Eye

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“…In a 5-year prospective study, Gambato and colleagues used IVCM to evaluate the safety of adjuvant mitomycin C in retarding the development of haze post-PRK. 299 They established that the corneal epithelium and subbasal nerve plexus remain largely unaffected even 5 years after mitomycin C-assisted PRK, thereby indicating its corneal safety. 299 …”

Section: Corneal Nerve Alterations After Corneal Surgerymentioning

confidence: 99%

In Vivo Confocal Microscopy of Corneal Nerves in Health and Disease

2017

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In vivo confocal microscopy (IVCM) is becoming an indispensable tool for studying corneal physiology and disease. Enabling the dissection of corneal architecture at a cellular level, this technique offers fast and noninvasive in vivo imaging of the cornea with images comparable to that of ex vivo histochemical techniques. Corneal nerves bear substantial relevance to clinicians and scientists alike, given their pivotal roles in regulation of corneal sensation, maintenance of epithelial integrity, and proliferation and promotion of wound healing. Thus, IVCM offers a unique method to study corneal nerve alterations in a myriad of conditions, such as ocular and systemic diseases and following corneal surgery, without altering the tissue microenvironment. Of particular interest has been the correlation of corneal subbasal nerves to their function, which has been studied in normal eyes, contact lens wearers, and patients with keratoconus, infectious keratitis, corneal dystrophies, and neurotrophic keratopathy. Longitudinal studies have applied IVCM to investigate the effects of corneal surgery on nerves, demonstrating their regenerative capacity. IVCM is increasingly important in the diagnosis and management of systemic conditions such as peripheral diabetic neuropathy and, more recently, in ocular diseases. In this review, we outline the principles and applications of IVCM in the study of corneal nerves in various ocular and systemic diseases.

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“…Nerve fiber density was calculated using an image processing computer tool, the Neuron J program, which traces the nerve fibers [8,9]. Nerve fiber density (μm/mm 2 ) for each image was calculated as the total length of the nerves (micrometers) divided by the area of the image (0.132 mm 2 ) [10]. The number of nerve beadings was defined as the number of hyper-reflective points in 100 μm of the best focused fiber, chosen by the operator [11].…”

Section: Image Analysismentioning

confidence: 99%