Mitomycin C modulation of corneal wound healing after photorefractive keratectomy in highly myopic eyes.
OBJECTIVE
To evaluate the role of topical mitomycin C in corneal wound healing (CWH) after photorefractive keratectomy (PRK) in highly myopic eyes.


METHODS
Prospective, double-masked, randomized clinical trial.


METHODS
Seventy-two eyes of 36 patients affected by high (>7 diopters) myopia.


METHODS
In each patient, one eye was randomly assigned to PRK with intraoperative topical 0.02% mitomycin C application, and the fellow eye was treated with a placebo. Postoperatively, mitomycin C-treated eyes received artificial tears (3 times daily, tapered in 3 months), whereas the fellow eye was treated with fluorometholone sodium 2% and artificial tears (3 times daily, tapered in 3 months).


METHODS
Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA), contrast sensitivity, manifest refraction, and biomicroscopy. Contrast sensitivity was determined using the Pelli-Robson chart. Corneal confocal microscopy documented CWH.


RESULTS
Mean follow-up was 18 months (range, 12-36). No side effects or toxic effects were documented. At 12-month follow-up examination, UCVAs (logarithm of the minimum angle of resolution) were 0.4+/-0.48 and 0.5+/-0.53 (P = .03) in mitomycin C-treated eyes and corticosteroid-treated eyes, respectively. At 1 year, corneal haze developed in 20% of corticosteroid-treated eyes, versus 0% of mitomycin C-treated eyes. At 12, 24, and 36 months, corneal confocal microscopy showed activated keratocytes and extracellular matrix significantly more evident in untreated eyes (Ps = 0.004, 0.024, and 0.046, respectively).


CONCLUSIONS
Topical intraoperative application of 0.02% mitomycin C can reduce haze formation in highly myopic eyes undergoing PRK.
Gambato
Catia
C
Refractive Surgery Service and Antimetabolite Therapy Research Unit, Department of Ophthalmology, University of Padova, Padova, Italy.
Ghirlando
Alessandra
A
Moretto
Erika
E
Busato
Fabiola
F
Midena
Edoardo
E
D000287:Administration, Topical; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D015350:Contrast Sensitivity / Q000187:drug effects; D003315:Cornea / Q000187:drug effects*; D003318:Corneal Opacity / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care; D054018:Lasers, Excimer; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009216:Myopia / Q000601:surgery*; D009883:Ophthalmic Solutions; D018903:Photorefractive Keratectomy; D011446:Prospective Studies; D014792:Visual Acuity / Q000187:drug effects; D014945:Wound Healing / Q000187:drug effects*
D000903:Antibiotics, Antineoplastic; D009883:Ophthalmic Solutions; D016685:Mitomycin