Low-dose mitomycin C as a prophylaxis for corneal haze in myopic surface ablation.
OBJECTIVE
To evaluate the efficacy of low-dose (0.002%) mitomycin C (MMC) vs no prophylactic MMC (control) in reducing corneal haze after surface laser ablation.


METHODS
Two-year retrospective follow-up study performed in Jaipur, India.


METHODS
Ninety-two eyes with no MMC application and 83 eyes with 0.002% MMC application during laser epithelial keratomileusis (LASEK) were analyzed in a retrospective chart review with one month, two months, three months, six months, one year, and two years of postoperative follow-up. Postoperative haze, visual acuity, and efficacy ratio (EFFR) then were analyzed statistically.


RESULTS
The no-dose MMC and low-dose MMC groups were statistically similar except for a thinner corneal pachymetry (P < .001), higher spherical equivalent error (P = .006), and smaller ablation zone (P = .009) in eyes not treated with MMC when subjected to univariate analysis. Multivariate analysis was used to overcome the preoperative statistical differences among the two groups. Eyes treated with low-dose MMC (0.002%) demonstrated statistically less haze at all postoperative time points and in each myopic subgroup (P < .001). The postoperative uncorrected visual acuity (UCVA) and EFFR, however, showed no difference between the groups, except for better EFFR with MMC at one month (P < .001) and two months (P = .034).


CONCLUSIONS
Low-dose MMC (0.002%) in eyes after LASEK results in less corneal haze than in eyes not receiving this agent. Concerns regarding the potential toxicity of MMC make a 10-fold less concentration more desirable in refractive surgery. Further comparative study of low- vs higher-dose MMC is recommended to characterize its clinical benefit fully.
Thornton
Ivey
I
Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Puri
Ashok
A
Xu
Meng
M
Krueger
Ronald R
RR
D000293:Adolescent; D000328:Adult; D003315:Cornea / Q000187:drug effects; D003318:Corneal Opacity / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049008:Keratectomy, Subepithelial, Laser-Assisted; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D009216:Myopia / Q000601:surgery*; D019384:Nucleic Acid Synthesis Inhibitors / Q000008:administration & dosage*; D011183:Postoperative Complications / Q000517:prevention & control*; D011292:Premedication; D012189:Retrospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity
D019384:Nucleic Acid Synthesis Inhibitors; D016685:Mitomycin