One-year outcomes of a bilateral randomised prospective clinical trial comparing PRK with mitomycin C and LASIK.
OBJECTIVE
To compare 1-year follow-up results of photorefractive keratectomy (PRK) with mitomycin C (MMC) and laser in situ keratomileusis (LASIK) for custom correction of myopia.


METHODS
Eighty-eight eyes of 44 patients with moderate myopia were randomised to PRK with 0.002% MMC for 1 min in one eye and LASIK in the fellow eye. The 1-year follow-up was evaluated.


RESULTS
There were no differences between LASIK and MMC-PRK eyes preoperatively. Forty-two patients completed the 1-year follow-up. MMC-PRK eyes achieved better uncorrected visual acuity (p = 0.03) and better best-spectacle-corrected visual acuity (p<0.001) 1 year after surgery. SE did not differ in the two groups during follow-up (p = 0.12). Clinically significant haze was not found in surface ablation eyes. LASIK eyes showed a greater higher-order aberration (p = 0.01) and lower contrast sensitivity (p<0.05) than MMC-PRK eyes postoperatively. Excellent vision was reported in 64% of LASIK and 74% of MMC-PRK eyes 1 year after surgery. The corneal resistance factor and corneal hysteresis (ORA, Reichert) were higher in LASIK than in MMC-PRK eyes (p<0.01) at the last follow-up.


CONCLUSIONS
Wavefront-guided PRK with 0.002% MMC was more effective than wavefront-guided LASIK for correction of moderate myopia. Further research is necessary to determine the optimal concentration, exposure time and long-term corneal side effect of MMC.
Wallau
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Vision Institute, Federal University of São Paulo, Department of Ophthalmology, São Paulo, Brazil. anewallau@hotmail.com
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D000328:Adult; D001696:Biomechanical Phenomena; D003131:Combined Modality Therapy; D015350:Contrast Sensitivity; D003315:Cornea / Q000503:physiopathology; D003318:Corneal Opacity / Q000209:etiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use*; D009216:Myopia / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D019384:Nucleic Acid Synthesis Inhibitors / Q000627:therapeutic use*; D018903:Photorefractive Keratectomy / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
D019384:Nucleic Acid Synthesis Inhibitors; D016685:Mitomycin