Comparison of laser epithelial keratomileusis with and without mitomycin C for wavefront customized surface ablations.
OBJECTIVE
To investigate the efficacy of mitomycin C (MMC) in preventing haze formation in surface wavefront customized ablations with successful refractive treatment (laser epithelial keratomileusis [LASEK]) and to evaluate the safety of this technique on corneal stroma and endothelium.


METHODS
This study was a prospective, double-masked, randomized clinical trial involving 52 eyes (30 placebo and 22 MMC) of 26 patients. The manifest refractive spherical equivalent (MRSE), best spectacle-corrected visual acuity, uncorrected visual acuity, corneal pachymetry, topography, aberrometry, endothelial specular microscopy, contrast sensitivity, corneal confocal microscopy, and complaints of pain via a subjective questionnaire were recorded preoperatively and 90 days postoperatively.


RESULTS
The mean MRSE at 90 days postoperatively was -0.56 diopters (D) (-4.95 +/- 1.85 D, range: -8.00 to -1.62 D) for the MMC group and -0.49 D (-4.51 +/- 1.81 D, range: -7.75 to -2.25 D) for the placebo group. Higher order aberrations were similar between the placebo and MMC groups 90 days postoperatively (0.538 +/- 0.228 microm and 0.478 +/- 0.134 microm, respectively). Analysis of the endothelial cell count indicated a statistically significant decrease in endothelial cell density (P = .017) after LASEK, independent of MMC use.


CONCLUSIONS
The predictability of the final target refraction, induction of high order aberrations, and improvement in contrast sensitivity proved that the use of MMC was equally safe when compared to procedures that did not use MMC. In addition, the procedure was efficient in the prevention of corneal haze.
Nakano
Eliane Mayumi
EM
Excimer Laser Santa Cruz, São Paulo, Brazil. mayuminakano@uol.com.br
Bains
Harkaran S
HS
Hirai
Flavio Eduardo
FE
Portellinha
Waldir
W
Oliveira
Marivaldo
M
Nakano
Kozo
K
D000328:Adult; D002452:Cell Count; D015350:Contrast Sensitivity; D003315:Cornea / Q000473:pathology; D003318:Corneal Opacity / Q000209:etiology / Q000517:prevention & control*; D003941:Diagnostic Techniques, Ophthalmological; D004311:Double-Blind Method; D004728:Endothelium, Corneal / Q000473:pathology; D005260:Female; D006801:Humans; D049008:Keratectomy, Subepithelial, Laser-Assisted / Q000009:adverse effects*; D008297:Male; D018613:Microscopy, Confocal; D016685:Mitomycin / Q000009:adverse effects / Q000627:therapeutic use*; D019384:Nucleic Acid Synthesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012029:Refraction, Ocular; D016896:Treatment Outcome
D019384:Nucleic Acid Synthesis Inhibitors; D016685:Mitomycin