Impact on the corneal endothelium of mitomycin C during photorefractive keratectomy.
OBJECTIVE
This brief review examines both basic science and clinical studies to evaluate the potential impact on the health of the corneal endothelium of mitomycin C (MMC) usage during photorefractive keratectomy (PRK).


METHODS
The mechanism of action and consequences of MMC are reviewed within the context of in vitro, animal, and clinical studies and a hypothesis of how this vital cell layer responds to MMC at both the cellular and clinical levels is formed.


RESULTS
Seven basic science studies were reviewed demonstrating significant MMC toxicity to corneal endothelial cells. Of the five clinical studies reviewed, three demonstrated no effect on corneal endothelial density, whereas two studies found significant cell loss after MMC usage.


CONCLUSIONS
Although all of the basic science studies reviewed highlight the toxicity of MMC on the corneal endothelium, current clinical studies are less conclusive. Given the corneal penetration of MMC and the fragile nature of the corneal endothelium, additional follow-up studies are needed to determine the long-term impact of MMC usage during PRK on the corneal endothelium.
Roh
Danny S
DS
Department of Ophthalmology, UPMC Eye and Ear Institute, University of Pittsburgh School of Medicine, PA, USA.
Funderburgh
James L
JL
D000477:Alkylating Agents / Q000633:toxicity*; D000818:Animals; D002452:Cell Count; D004728:Endothelium, Corneal / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D054018:Lasers, Excimer / Q000627:therapeutic use; D016685:Mitomycin / Q000633:toxicity*; D018903:Photorefractive Keratectomy
D000477:Alkylating Agents; D016685:Mitomycin