Outcomes of photorefractive keratectomy with intraoperative mitomycin-C

ABSTRACT

To report the efficacy, safety, predictability and complications of photo-refractive keratectomy [PRK] with intraoperative application of mitomycin-C [MMC]. This historical cohort study was performed on 1,250 eyes of 625 patients who underwent PRK using the Technolas 217 excimer laser machine by a single surgeon with intraoperative use of MMC 0.02% up to 2 minutes, depending on depth of ablation. A complete ophthalmologic examination was performed which included refraction, uncorrected visual acuity [UCVA], best-corrected visual acuity [BCVA] and slitlamp biomicroscopy. Outcomes were analyzed after one year of follow-up. The mean preoperative spherical equivalent refractive error was -4.85 +/- 2.27 [range, -2.50 to -13.5] diopters [D]. Mean depth of ablation was 89 +/- 22 microns and mean time to reepithelialization was 4.5 +/- 1.7 days. At final follow-up, UCVA of 20/20 and 20/40 or more was achieved in 92.1% and 99.2% of eyes, respectively. One year post-operatively, 69.4% and 91% of eyes were within +/- 0.50 D and +/- 1.00 D of emmetropia. Overall, 62 eyes [4.9%] developed one or two lines of decrease in BCVA, and 50 eyes [4%] developed corneal haze which was grade 1 or 2 in most cases; grade 3 and 4 corneal haze was found in 4 and 2 eyes, respectively. No other adverse event was noted during the study period. PRK with intraoperative application of MMC provides excellent visual outcomes with acceptable safety and predictability, and entails minimal side effects