Mitomycin-C in hyperopic photorefractive keratectomy.

Author(s): Leccisotti A

Affiliation(s): Ophthalmic Surgery Unit, Casa di Cura Rugani, Siena, Italy. leccisotti@libero.it

Publication date & source: 2009-04, J Cataract Refract Surg., 35(4):682-7.

Publication type: Randomized Controlled Trial

PURPOSE: To evaluate the effects of topical mitomycin-C (MMC) after hyperopic photorefractive keratectomy (PRK). SETTING: Private practice, Siena, Italy. METHODS: In this prospective study, a sponge with 0.2 mg/mL MMC or balanced salt solution (controls) was placed on the stroma for 45 seconds after PRK performed using a Technolas 217z laser. After epithelialization, fluorometholone 0.1% eyedrops were used for 4 months in both groups. RESULTS: The MMC group comprised 88 eyes (mean spherical equivalent [SE] +3.51 diopters [D] +/- 1.04) and the control group, 91 eyes (mean SE +3.50 +/- 1.03 D). At 18 months, the mean SE was -0.10 +/- 0.37 D and 0.22 +/- 0.70 D, respectively, and the mean defocus equivalent, 0.34 +/- 0.32 D and 0.69 +/- 0.74 D, respectively (both P<.05). The mean best spectacle-corrected visual acuity (BSCVA) was 0.06 +/- 0.08 logMAR in the MMC group and 0.08 +/- 0.10 logMAR in the control group; 2 eyes and 11 eyes, respectively, lost more than 0.1 logMAR of BSCVA. The mean uncorrected visual acuity (UCVA) was 0.13 +/- 0.11 logMAR in the MMC group and 0.21 +/- 0.20 logMAR in the control group (P<.05). The UCVA was better than 20/40 in 94% of eyes and 80% of eyes, respectively. The efficacy index was 0.87 and 0.67, respectively. Haze at 18 months was 0.05 +/- 0.11 in the MMC group and 0.23 +/- 0.46 in the control group (P<.05). No endothelial damage was observed in either group. CONCLUSION: Mitomycin-C prevented haze formation and improved predictability and efficacy. No adverse effects occurred.