Toxicity and Long-term Utility of 0.02% Mitomycin C in Lasek
Keywords:
Lasek, mitomycin C, toxicity of mitomycin C, usefulness of mitomycin CAbstract
To evaluate the long-term toxicity and usefulness of mitomycin C in subepithelial keratectomy.
Methods: A descriptive, longitudinal, and prospective study was conducted in 73 eyes with subepithelial keratectomy and 0.02% mitomycin C at the Hermanos Ameijeiras Hospital. Visual acuity without and with correction, refractive variables, corneal endothelial cell density, coefficient of variation, hexagonality, degree, time of onset, and duration of haze were studied.
Results: The mean age was 28.2 ± 7.2 years, and males were predominant (63.2%). The sphere and cylinder values at two years were -0.25 ± 0.44 and -0.09 ± 0.36, respectively (p < 0.001). Visual acuity without and with correction at two years was equal to 0.99 (p < 0.001). Corneal haze occurred in 4.1% of cases and was grade 2 with no impact on visual acuity. All treatments met the criteria for nontoxic and useful use at two years: endothelial cell count above 2000 cells/mm2, coefficient of variation less than 30%, hexagonality greater than 40%, no signs of corneal decompensation, and the onset of low, transient, and unaffected haze visual acuity.
Conclusion: The use of 0.02% mitomycin C is useful and nontoxic in the long term for the prevention of corneal haze in Lasek.
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References
1. Wilson SE. Biology of keratorefractive surgery- PRK, PTK, Lasik, SMILE, inlays and other refractive procedures. Exp Eye Res 2020;198:108136. DOI: 10.1016/j.exer.2020.108136
2. Poyales F, Garzón N, Mendicute J, Illarramendi I, Caro P, Jáñez O, et al. Corneal densitometry after photorefractive keratectomy, laser-assisted in situ keratomileusis, and small-incision lenticule extraction. Eye. 2017;31(12):1647-54. DOI: 10.1038/eye.2017.107
3. Moshirfar M, Villarreal A, Thomson AC, West WB, McCabe SE, Quiñonez Zanabria E, et al. PRK Enhancement for Residual Refractive Error After Primary PRK: A Retrospective Study. Ophthalmol Ther. 2021;10(1):175-85. DOI: 10.1007/s40123-021-00331-8
4. Al-Tobaigy F. Efficacy, predictability, and safety of laser-assisted subepithelial keratectomy for the treatment of myopia and myopic astigmatism. Middle East Afr J Ophthalmol. 2012;19(3):304. DOI: 10.4103/0974-9233.97931
5. Li SM, Zhan S, Li SY, Peng XX, Hu J, Law HA, et al. Laser-assisted subepithelial keratectomy (Lasek) versus photorefractive keratectomy (PRK) for correction of myopia. Cochrane Database Syst Rev. 2016 DOI: 10.1002/14651858.cd009799.pub2
6. Zhao LQ, Zhu H, Li LM. Laser-Assisted Subepithelial Keratectomy versus Laser In Situ Keratomileusis in Myopia: A Systematic Review and Meta-Analysis. ISRN Ophthalmol. 2014;2014:672146. DOI: 10.1155/2014/672146
7. Al Arfaj K, Hantera MM. Comparison of LASEK, mechanical microkeratome LASIK and Femtosecond LASIK in low and moderate myopia. Saudi J Ophthalmol. 2014;28(3):214-9. DOI: 10.1016/j.sjopt.2013.10.002
8. Moshirfar M, Wang Q, Theis J, Porter KC, Stoakes IM, Payne CJ, et al. Management of Corneal Haze After Photorefractive Keratectomy. Ophthalmol Ther. 2023. DOI: 10.1007/s40123-023-00782-1
9. Margo JA, Munir WM. Corneal Haze Following Refractive Surgery: A Review of Pathophysiology, Incidence, Prevention, and Treatment. International ophthalmology clinics.2023;56(2):111–125. DOI: 10.1097/IIO.0000000000000112
10. Santhiago MR, Netto MV, Wilson SE. Mitomycin C: Biological Effects and Use in Refractive Surgery. Cornea. 2012;31(3):311-21. DOI: 10.1097/ico.0b013e31821e429d
11. Lee KS, Ko DA, Kim ES, Kim MJ, Tchah H, Kim JY. Bevacizumab and rapamycin can decrease corneal opacity and apoptotic keratocyte number following photorefractive keratectomy. Investig Opthalmology Amp Vis Sci. 2012;53(12):7645. DOI: 10.1167/iovs.12-10494
12. Mohammad Rabei H, Moravej R, Almasi Nasrabadi M, Rezazadeh P, Manafi N, Noorizadeh F. Effect of mitomycin-C on corneal endothelial cell parameters after refractive surface ablation procedures. Med Hypothesis Discov Innov Ophthalmol. 2022;10(4):156-64. DOI: 10.51329/mehdiophthal1434
13. Al-Mohaimeed MM. Effect of prophylactic mitomycin c on corneal endothelium following transepithelial photorefractive keratectomy in myopic patients. Clin Ophthalmol. 2022;16:2813-22. DOI: 10.2147/opth.s375587
14. Tirado OM, Hernández A. Uso de la Mitomicina C en la prevención del haze corneal. Rev Cub Oftalmol. 2011 [acceso 29/10/2024];24(1):100-10. http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864-21762011000100010&lng=es
15. Djodeyre MR, Ortega Usobiaga J, Beltran J, Baviera J. Long-term comparison of laser in situ keratomileusis versus laser surface ablation in corneas thinner than 470 μm. J Cataract Amp Refract Surg. 2012;38(6):1034-42. DOI: 10.1016/j.jcrs.2011.12.036
16. Nassaralla BA, McLeod SD, Nassaralla JJ. Prophylactic mitomycin c to inhibit corneal haze after photorefractive keratectomy for residual myopia following radial keratotomy. J Refract Surg. 2007;23(3):226-32. DOI: 10.3928/1081-597x-20070301-04
17. Amoozadeh J, Aliakbari S, Behesht-Nejad AH, Seyedian MA, Rezvan B, Hashemi H. Confocal microscopy of corneal stroma and endothelium after LASIK and PRK. J Refract Surg. 2009;25(Sup):963-7. DOI: 10.3928/1081597x-20090915-12
18. Al-Mohaimeed MM. Effect of prophylactic mitomycin c on corneal endothelium following transepithelial photorefractive keratectomy in myopic patients. Clin Ophthalmol. 2022;25(16):2813-2822. DOI: 10.1016/j.ophtha.2015.01.019
19. Hashemian MN, Moghimi S, Fard MA, Fallah MR, Mansouri MR. Corneal endothelial cell density and morphology in normal Iranian eyes. BMC Ophthalmol. 2006;6(1). DOI: 10.1186/1471-2415-6-9
20. Majmudar PA, Schallhorn SC, Cason JB, Donaldson KE, Kymionis GD, Shtein RM, et al. Mitomycin C in corneal surface excimer laser ablation techniques: a report by the American Academy of Ophthalmology. Ophthalmol.2 015;122(6):1085-95. DOI: 10.1016/j.ophtha.2015.01.019
21. Lee DH, Chung HS, Jeon YC, Boo SD, Yoon YD, Kim JG. Photorefractive keratectomy with intraoperative mitomycin-C application. J Cataract Amp Refract Surg. 2005;31(12):2293-8. DOI: 10.1016/j.jcrs.2005.05.027
22. Sy ME, Zhang L, Yeroushalmi A, Huang D, Hamilton RD. Effect of mitomycin-C on the variance in refractive outcomes after photorefractive keratectomy. J Cataract Amp Refract Surg. 2014;40(12):1980-4. DOI: 10.1016/j.jcrs.2014.02.048
23. Tomás JJ, Murueta-Goyena Larrañaga A, Hanneken L. Corneal regeneration after photorefractive keratectomy: A review. J Optom. 2015;8(3):149-69. DOI: 10.1016/j.optom.2014.09.001
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