Evaluation of the prophylactic use of mitomycin-C to inhibit haze formation after photorefractive keratectomy.
OBJECTIVE
To evaluate the results of the prophylactic use of mitomycin-C to inhibit haze formation after excimer laser photorefractive keratectomy (PRK) for medium and high myopia in eyes that were not good candidates for laser in situ keratomileusis (LASIK).


METHODS
Carones Ophthalmology Center, Milan, Italy.


METHODS
This prospective randomized masked study comprised 60 consecutive eyes (60 patients). The inclusion criteria were a spherical equivalent correction between -6.00 and -10.00 diopters (D) and inadequate corneal thickness to allow a LASIK procedure with a residual stromal thickness of more than 250 microm. The eyes were divided into 2 groups according to the randomization protocol. After PRK, the study group eyes were treated with a single intraoperative dose of mitomycin-C (0.2 mg/mL), applied topically with a soaked microsponge placed over the ablated area and maintained for 2 minutes. The control eyes did not receive this treatment. Refraction, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and slitlamp evidence of corneal opacity (haze) or other visible complications were evaluated.


RESULTS
No toxic or side effects were encountered postoperatively. No study group eye had a haze rate higher than 1 during the 6-month follow-up; 19 eyes (63%) in the control group did (P =.01). At 6 months, the between-group difference in the refractive outcome was statistically significant (P =.05), with 26 study group eyes (87%) and 14 control eyes (47%) within +/-0.50 D of the attempted correction. No study group eye had a BCVA loss during the follow-up; 7 control eyes had lost 1 to 3 lines at 6 months (P =.0006).


CONCLUSIONS
The prophylactic use of a diluted mitomycin-C 0.02% solution applied intraoperatively in a single dose after PRK produced lower haze rates, better UCVA and BCVA results, and more accurate refractive outcomes than those achieved in the control group.
Carones
Francesco
F
Carones Ophthalmology Center, Via Pietro Mascagni 20, 20122 Milan, Italy. fcarones@carones.com
Vigo
Luca
L
Scandola
Elena
E
Vacchini
Letizia
L
D000287:Administration, Topical; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D003315:Cornea / Q000601:surgery*; D003318:Corneal Opacity / Q000517:prevention & control*; D004311:Double-Blind Method; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009216:Myopia / Q000601:surgery*; D009883:Ophthalmic Solutions; D018903:Photorefractive Keratectomy; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D016037:Single-Blind Method; D014792:Visual Acuity
D000903:Antibiotics, Antineoplastic; D009883:Ophthalmic Solutions; D016685:Mitomycin