Effect of intraoperative mitomycin-C application on epithelial regeneration after transepithelial photorefractive keratectomy

Abstract

Purpose:To investigate the effect of mitomycin-C (MMC) intraoperative application on postoperative corneal epithelial remodeling, haze incidence, and refractive correction in transepithelial photorefractive keratectomy (transPRK).Setting:Eye Hospital of Wenzhou Medical University, Wenzhou, China.Design:Prospective randomized controlled study.Methods:Eyes that completed all follow-ups were included. Epithelial thickness (ET) map measurement was conducted preoperatively and at 1 week, and at 1 month, 3 months, and 6 months postoperatively, generating ET in central, paracentral, and midperipheral zones. The difference between postoperative and preoperative ET (ΔET) was computed for each zone. During follow-up, haze incidence and visual acuity were assessed and compared between groups.Results:A total of 100 eyes completed all follow-up, including 40 eyes treated with MMC in MMC group and 60 eyes in control group without MMC treatment. For ΔET, between-group difference was found in midperipheral (P =.011) zone at 1 week postoperatively and in central (P =.036) and paracentral zones (P =.039) at 1 month postoperatively. Haze incidence was lower in MMC group at 1 week and 1 month postoperatively (P =.035 and.018, respectively). Safety index (postoperative uncorrected distance visual acuity/preoperative corrected distance visual acuity [CDVA]) and efficacy index (postoperative CDVA/preoperative CDVA) were higher in MMC group (P =.012 and P =.036, respectively) at 1 month postoperatively. No difference was found after 3 months postoperatively.Conclusions:With a temporary impact on corneal epithelial regeneration and refractive correction, intraoperative MMC application in transPRK decreased the haze incidence but had no effect on epithelial remodeling. © 2021 Elsevier Inc.. All rights reserved.