title: Alcohol-assisted debridement in PRK with intraoperative mitomycin C.
abstract: OBJECTIVE
  To compare corneal stromal and endothelial cells after photorefractive keratectomy with intraoperative mitomycin C in alcohol-assisted versus mechanical epithelial debridement using confocal microscopy.
  
  
  METHODS
  This prospective randomized comparative study was performed on 88 eyes (44 patients) with myopia up to -6.00 diopters. The right eye of each patient was randomly assigned to either mechanical or alcohol-assisted groups, and the left eye was assigned to the alternate group. Confocal microscopy was performed preoperatively and at 3 months postoperatively. The main outcome measures were epithelial thickness; number of keratocytes in the anterior, mid-, and posterior stroma; and characteristics of the central corneal endothelial cells in terms of density, mean cell area, and polymegathism and hexagonality.
  
  
  RESULTS
  Three months after surgery, no statistically significant difference was noted between the study groups in terms of epithelial thickness. We also found no statistically significant difference in central corneal endothelial cells regarding cell density, mean cell area, hexagonality, or polymegathism. Compared with baseline values, the density of mid- and posterior stromal keratocytes showed no significant change in either group, whereas it decreased significantly in the anterior stroma in both groups 3 months after surgery.
  
  
  CONCLUSIONS
  We found that the adverse effects of photorefractive keratectomy with mitomycin C on central corneal endothelial cells were comparable between the mechanical and alcohol-assisted epithelial debridement groups and the significant decrease in postoperative keratocyte density in anterior stroma was comparable between the two groups. The choice of their application could be left to the discretion of the ophthalmologist.
authors: *MD †MD, MS ‡MSc §MD, MPH ∥MD, MIH Department of Ophthalmology, Imam Hossein Medical Center (NadN), Ophthalmic Research Center (NadN, SS), and Clinical Research and Development Center, Imam Hossein Medical Center (KS), Shahid Beheshti University of Medical Sciences, Tehran, Iran; Vanak Eye Surgery Center, Tehran, Iran (NadN, NarN); Basir Eye Safety Research Center, Basir Eye Clinic, Tehran, Iran (KS); Jules Stein Eye Institute, University of California at Los Angeles, Los Angeles, California (MH, SM, NarN); Department of Ophthalmology, Imam Khomeini Medical Center, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khuzestan, Iran (SN); and Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran (NP).
authors: Nader
authors: N
authors: Nassiri
authors: Kourosh
authors: K
authors: Sheibani
authors: Sare
authors: S
authors: Safi
authors: Maryam
authors: M
authors: Haghnegahdar
authors: Saman
authors: S
authors: Nassiri
authors: Nekoo
authors: N
authors: Panahi
authors: Shiva
authors: S
authors: Mehravaran
authors: Nariman
authors: N
authors: Nassiri
mesh_terms: D000328:Adult; D000477:Alkylating Agents / Q000008:administration & dosage*; D002452:Cell Count; D060527:Corneal Keratocytes / Q000473:pathology; D003319:Corneal Stroma / Q000473:pathology; D003646:Debridement / Q000379:methods*; D004728:Endothelium, Corneal / Q000473:pathology; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D054018:Lasers, Excimer / Q000627:therapeutic use*; D008297:Male; D018613:Microscopy, Confocal; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D009216:Myopia / Q000601:surgery; D018903:Photorefractive Keratectomy / Q000379:methods*; D011446:Prospective Studies; D012997:Solvents / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000477:Alkylating Agents; D012997:Solvents; D000431:Ethanol; D016685:Mitomycin