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Volume 142, Issue 3, Pages 400-404 (September 2006)


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Intraoperative Mitomycin and Corneal Endothelium After Photorefractive Keratectomy

Alberto J. Morales, MDa, David Zadok, MDab, Rolando Mora-Retana, MDa, Eduardo Martínez-Gama, MDa, Nora E. Robledo, ODa, Arturo S. Chayet, MDaCorresponding Author Informationemail address

Accepted 13 April 2006. published online 23 May 2006.

Purpose

To determine whether there is an increased risk to the corneal endothelium when mitomycin C (MMC) is administered after photorefractive keratectomy (PRK).

Design

Prospective, randomized, double-blind, placebo-controlled crossover trial.

Methods

Corneal endothelium was analyzed preoperatively and postoperatively in 18 eyes of nine patients who were administered either MMC- or balanced salt solution (BSS)–supplemented PRK at Codet Aris Vision, Tijuana, Mexico. After laser ablation, one eye was randomly assigned to intraoperative topical MMC 0.02% treatment for 30 seconds, and the fellow eye (the control eye) was treated in a standard fashion with topical BSS. Preoperative pachymetry and endothelial cell count were performed and compared with postoperative measurements after one month and three months. Main outcome measure studied was endothelial cell loss.

Results

There was no significant difference in the preoperative endothelial cell count between the 2 groups: MMC group 2835 ± 395, control group 2779 ± 492, P = .62. In the control group, at one month and three months the difference in the endothelial cell count was not statistically significant (P = .27, P = .14, respectively). However, in the MMC group the endothelial cell loss was statistically significant: at one month 14.7 ± 5.1%, and at three months 18.2 ± 9.0% (P = .0006, P = .002, respectively).

Conclusions

The use of intraoperative topical MMC 0.02% for 30 seconds after PRK may affect the endothelial cell count.

a Codet-Aris Vision Institute, Tijuana, Mexico

b Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Corresponding Author InformationInquiries to Arturo S. Chayet, MD, Codet-Aris Vision Institute, Padre Kino 10159, Tijuana, BC, 22032, Mexico

PII: S0002-9394(06)00502-2

doi:10.1016/j.ajo.2006.04.029


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