Effects of mitomycin-C on tear film, corneal biomechanics, and surface irregularity in mild to moderate myopic surface ablation: Preliminary results

• Published in: Journal of cataract and refractive surgery Vol. 40; no. 6; pp. 937 - 942
• Main Authors: Mohammadi, Seyed-Farzad, MD, FICO, Ashrafi, Elham, MSc, PhD, Norouzi, Nima, MD, Abdolahinia, Tahereh, MSc, Mir-AbouTalebi, Mohsen, BSc, Jabbarvand, Mahmoud, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2014
• Subjects: Adult; Alkylating Agents - administration & dosage; Alkylating Agents - adverse effects; Biomechanical Phenomena - drug effects; Cornea - drug effects; Cornea - physiopathology; Double-Blind Method; Elasticity - drug effects; Female; Humans; Lasers, Excimer - therapeutic use; Male; Mitomycin - administration & dosage; Mitomycin - adverse effects; Myopia - physiopathology; Myopia - surgery; Ophthalmology; Photorefractive Keratectomy - methods; Prospective Studies; Refraction, Ocular - physiology; Tears - physiology; Visual Acuity - physiology; Young Adult
• ISSN: 0886-3350; 1873-4502
• DOI: 10.1016/j.jcrs.2013.10.043

Purpose To assess the effect of mitomycin-C (MMC) on the tear film, corneal biomechanics, and surface irregularity in surface ablation (photorefractive keratectomy [PRK]) for low to moderate myopia. Setting Refractive Surgery Unit, Farabi Eye Hospital, Tehran, Iran. Design Double-masked randomized clinical trial. Methods In patients with spherical equivalent myopia of −0.75 to −3.87 diopters (D) and astigmatism up to −1.75 D, the first eye was randomly assigned to the application of MMC 0.02% or a balanced salt solution for 15 seconds. The fellow eye received the alternate in a masked fashion after excimer photoablation. Results The study enrolled 60 patients. In fellow eyes, the changes in the tear-film index were comparable 1 month and 6 months postoperatively. There was no significant difference in changes in total higher-order aberrations, spherical aberration, coma, or Q values (Pentacam HR) between fellow eyes at 1 month and 6 months. There was a trend toward a higher asymmetry index at 1 month; however, a statistically significant drop was observed at 6 months in the MMC group ( P <.01). It was hypothesized that stromal remodeling was delayed, but better, in MMC-treated eyes. No haze was recorded at 6 months in either group. Conclusion Use of MMC in PRK did not appear to contribute significantly to surface irregularity, transient tear-film dysfunction, or biomechanical weakening of the cornea compared with PRK without MMC. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.