title: Systemic absorption of mitomycin-C when used in refractive surgery.
abstract: OBJECTIVE
  To determine whether corneal topical application of mitomycin-C (MMC) results in measurable plasma levels of systemic absorption.
  
  
  METHODS
  Madigan Army Medical Center, Refractive Surgery Center, Fort Lewis, Washington, and Micro-Constants Laboratory, San Diego, California, USA.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  The study comprised male and female active-duty soldiers having excimer laser photorefractive keratectomy with MMC. Patients who met inclusion criteria were asked to provide a blood sample immediately after being treated with MMC 0.2 mg/mL (0.02%) for 30 seconds. Human plasma samples were evaluated by liquid chromatography mass spectrometry to determine whether MMC was present.
  
  
  RESULTS
  Thirty samples were submitted for evaluation. There was zero detection of MMC in the submitted samples. The quantifiable limit was greater than 10.0 ng/mL. All samples were below this.
  
  
  CONCLUSIONS
  In this study of 30 patients with topical application of MMC for refractive surgery, there was no measurable evidence of systemic absorption. Although systemic absorption has been found with use in larger quantities, it was not known whether MMC toxicity concerns could be extrapolated to the refractive surgery population. This information allows counseling of patients on the extremely low likelihood of systemic absorption or toxicity following current techniques for refractive surgery.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Fort Campbell Army Department of Ophthalmology, Kentucky, USA. courtney.m.crawford@us.army.mil
authors.forename: Courtney
authors.initials: C
authors.lastname: Crawford
authors.forename: Darryl J
authors.initials: DJ
authors.lastname: Ainbinder
authors.forename: Robert
authors.initials: R
authors.lastname: Davis
authors.forename: Roger K
authors.initials: RK
authors.lastname: George
authors.forename: Bruce
authors.initials: B
authors.lastname: Rivers
authors.forename: Mark A
authors.initials: MA
authors.lastname: Wingerd
authors.forename: Mark
authors.initials: M
authors.lastname: Torres
authors.forename: Aaron
authors.initials: A
authors.lastname: Dent
mesh_terms: D000042:Absorption; D000287:Administration, Topical; D000477:Alkylating Agents / Q000493:pharmacokinetics*; D016022:Case-Control Studies; D002853:Chromatography, Liquid; D005260:Female; D006801:Humans; D054018:Lasers, Excimer; D008297:Male; D016685:Mitomycin / Q000493:pharmacokinetics*; D018903:Photorefractive Keratectomy; D011446:Prospective Studies; D053719:Tandem Mass Spectrometry; D055815:Young Adult
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin