Photorefractive keratectomy with intraoperative mitomycin-C application.
OBJECTIVE
To evaluate the efficacy and safety of photorefractive keratectomy (PRK) with intraoperative application of mitomycin-C (MMC).


METHODS
Yonsei Eye Center, Seoul, South Korea.


METHODS
This retrospective noncomparative case series included 536 patients (1011 eyes) who had had PRK with intraoperative application of MMC using the Nidek EC-5000 excimer laser. Preoperative and postoperative best spectacle-corrected and uncorrected visual acuities, spherical equivalent (SE) refraction, corneal haze graded by slitlamp biomicroscopy, and endothelial cell density measured by specular microscopy were evaluated.


RESULTS
The mean preoperative SE was -7.82 diopters (D) +/- 2.64 (SD); 72% of eyes (732) were more than -6.00 D, and 28% (287) were more than -9.00 D. The mean follow-up was 13 months (range 6 to 27 months). Six months postoperatively, the mean postoperative SE was -0.14 +/- 0.62 D; 86% were within +/-0.50 D and 93% were within +/-1.00 D of desired refraction. Eighty-six percent had 20/20 or better visual acuity, and 98% were 20/40 or better. Regression of more than 1.00 D occurred in 78 eyes (7.6%), and it was more common in eyes with a preoperative SE of -9.00 D or worse (18%). Haze occurred in 32 eyes (3.17%), but in most cases it was limited to grade 1. Grades 2 and 3 haze occurred in 3 eyes and 2 eyes, respectively. The postoperative endothelial cell density measured by specular microscopy did not show a significant difference from preoperative measurements. Delayed epithelial healing was observed in 2 eyes.


CONCLUSIONS
Photorefractive keratectomy with intraoperative application of MMC was a safe procedure that produced excellent visual outcomes with few complications.
Department of Ophthalmology, Yonsei Eye Center, Seoul, South Korea. donghlee64@hananet.net
Dong H
DH
Lee
Hak Sung
HS
Chung
Young C
YC
Jeon
Sang D
SD
Boo
Young D
YD
Yoon
Jong G
JG
Kim
D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage* / Q000009:adverse effects; D003131:Combined Modality Therapy; D003315:Cornea / Q000187:drug effects* / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D054018:Lasers, Excimer; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage* / Q000009:adverse effects; D009216:Myopia / Q000601:surgery*; D018903:Photorefractive Keratectomy / Q000379:methods*; D012029:Refraction, Ocular; D012189:Retrospective Studies; D014792:Visual Acuity
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin