Abstract
Purpose
To compare MMC 0.002% efficacy in preventing haze after PRK in relation to MMC 0.02%.
Patients and methods
We conducted a prospective study with patients with myopia or myopic astigmatism undergoing PRK in the same conditions. After PRK, MMC was applied for 30 s in a concentration of 0.02% on the right eye (group 1) and 0.002% on the left eye (group 2). Age, gender, spherical equivalent and haze intensity (1, 3, 6 and 12 months postoperatively) were assessed. Haze was quantified at biomicroscopy (0–4 +). P < 0.05 was considered statistical significant.
Results
We evaluated 130 patients, 77 women and 53 men, with a mean age of 30.2 ± 9 years. The spherical equivalent was − 3.66 D in the group 1 and − 3.77 D in the group 2. In the 1st month after PRK, incidence of haze was 13.9% eyes in group 1 and 14.6% in group 2. In the 3rd month, incidence of haze was 50.0% eyes in group 1 and 48.5% in group 2 which presented with 3 +/4 + traces of haze. In the 12th month, incidence of haze was 7.7% eyes in group 1 and 5.4% in group 2. There was no correlation between haze and age (p = 0.279/0.333), gender (p = 0.345/0.367) or spherical equivalent (p = 0.100/0.054) in groups 1 and 2, respectively. There was no difference in haze between groups 1 and 2 (p = 0.56).
Conclusion
MMC 0.002% was effective in preventing haze after PRK. As MMC long-term safety has not been proved, we suggest its use in a lower concentration, in order to prevent potential complications.
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References
Santhiago MR, Netto MV, Wilson SE (2012) Mitomycin C: biological effects and use in refractive surgery. Cornea 31(3):311–321
Netto MV et al (2006) Effect of prophylactic and therapeutic mitomycin C on corneal apoptosis, cellular proliferation, haze, and long-term keratocyte density in rabbits. J Refract Surg 22:562–574
Naderi M, Ahmadi M, Jadidi K, Alishiri A, Rafizadeh P (2010) Comparison of standard and low dose mitomycin C in the prevention of corneal haze following photorefractive keratectomy. Iran J Ophthalmol 22(3):13–16
Teus MA, Benito-Llopis L, Alió JL (2009) Mitomycin C in corneal refractive surgery. Surv Ophthalmol 54:487–502
Netto MV, Mohan RR, Sinha S et al (2006) Stromal haze, myofibroblasts, and surface irregularity after PRK. Exp Eye Res 82:788–797
Diakonis VF et al (2014) Contralateral-eye study of surface refractive treatments: clinical and confocal microscopy evaluation. J Cataract Refract Surg 40:224–231
Lacayo GO III, Majmudar PA (2005) How and when to use mitomycin-C in refractive surgery. Curr Opin Ophthalmol 16:256–259
Thornton I, Puri A, Xu M, Krueger RR (2007) Low-dose mitomycin C as a prophylaxis for corneal haze in myopic surface ablation. Am J Ophthalmol 144:673–681
Majmudar PA et al (2000) Topical mitomycin-C for subepithelial fibrosis after refractive corneal surgery. Ophthalmology 107:89–94
Sia RK, Ryan DS, Edwards JD, Stutzman RD, Bower KS (2014) The U.S. army surface ablation study: comparison of PRK, MMC-PRK, and LASEK in moderate to high myopia. J Refract Surg 30(4):256–264
Virasch VV, Majmudar PA, Epstein RJ et al (2010) Reduced application time for prophylactic mitomycin C in photorefractive keratectomy. Ophthalmology 117:885–889
Hofmeister EM, Bishop FM, Kaupp SE, Schallhorn SC (2013) Randomized dose-response analysis of mitomycin-C to prevent haze after photorefractive keratectomy for high myopia. J Cataract Refract Surg 39:1358–1365
Gambato C, Ghirlando A, Moretto E, Busato F, Midena E (2005) Mitomycin C modulation of corneal wound healing after photorefractive keratectomy in highly myopic eyes. Ophthalmology 112:208–219
Crawford C et al (2013) Systemic absorption of mitomycin-C when used in refractive surgery. J Cataract Refract Surg 39:193–196
Song JS, Kim JH, Yang M, Sul D, Kim HM (2007) Mitomycin C concentration in cornea and aqueous humor and apoptosis in the stroma after topical mitomycin-C application. Effects of mitomycin-C application time and concentration. Cornea 26:461–467
Stojanovic A, Nitter TA (2001) Correlation between ultraviolet radiation level and the incidence of late-onset corneal haze after photorefractive keratectomy. J Cataract Refract Surg 27:404–410
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The authors declare that they have no conflict of interest.
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Setting: “Dr. Reinaldo Sieiro” and “Ocular Laser” Eye Clinics; Belo Horizonte; Minas Gerais; Brazil.
Project number and institution responsible for the approval of the Research Ethics Committee: 57213816.4.0000.5134/ Ethics Research Committee of “Faculdade de Ciências Médicas de Minas Gerais”.
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Coelho, L.M., Sieiro, R.O. Mitomycin C 0.02 and 0.002% efficacy in preventing haze after photorefractive keratectomy. Int Ophthalmol 39, 341–345 (2019). https://doi.org/10.1007/s10792-017-0817-7
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DOI: https://doi.org/10.1007/s10792-017-0817-7