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Photorefractive keratectomy with intraoperative mitomycin-C application

2005; Lippincott Williams & Wilkins; Volume: 31; Issue: 12 Linguagem: Inglês

10.1016/j.jcrs.2005.05.027

1873-4502

Dong Hoon Lee, Hak Sung Chung, Young Cheol Jeon, Sang Don Boo, Young Doo Yoon, Jong G. Kim,

Corneal Surgery and Treatments

To evaluate the efficacy and safety of photorefractive keratectomy (PRK) with intraoperative application of mitomycin-C (MMC).Yonsei Eye Center, Seoul, South Korea.This retrospective noncomparative case series included 536 patients (1011 eyes) who had had PRK with intraoperative application of MMC using the Nidek EC-5000 excimer laser. Preoperative and postoperative best spectacle-corrected and uncorrected visual acuities, spherical equivalent (SE) refraction, corneal haze graded by slitlamp biomicroscopy, and endothelial cell density measured by specular microscopy were evaluated.The mean preoperative SE was -7.82 diopters (D) +/- 2.64 (SD); 72% of eyes (732) were more than -6.00 D, and 28% (287) were more than -9.00 D. The mean follow-up was 13 months (range 6 to 27 months). Six months postoperatively, the mean postoperative SE was -0.14 +/- 0.62 D; 86% were within +/-0.50 D and 93% were within +/-1.00 D of desired refraction. Eighty-six percent had 20/20 or better visual acuity, and 98% were 20/40 or better. Regression of more than 1.00 D occurred in 78 eyes (7.6%), and it was more common in eyes with a preoperative SE of -9.00 D or worse (18%). Haze occurred in 32 eyes (3.17%), but in most cases it was limited to grade 1. Grades 2 and 3 haze occurred in 3 eyes and 2 eyes, respectively. The postoperative endothelial cell density measured by specular microscopy did not show a significant difference from preoperative measurements. Delayed epithelial healing was observed in 2 eyes.Photorefractive keratectomy with intraoperative application of MMC was a safe procedure that produced excellent visual outcomes with few complications.