Photorefractive keratectomy with mitomycin C after penetrating and lamellar keratoplasty.

Abstract

PURPOSE:

To assess the safety and efficacy of photorefractive keratectomy with mitomycin C (PRK-MMC) to correct refractive errors after corneal transplantation.

METHODS:

This was a prospective and noncomparative study of 36 eyes that underwent PRK-MMC after penetrating (n = 34) or lamellar (n = 2) keratoplasty. After mechanical epithelial removal and photoablation, a sponge with mitomycin C 0.02% was applied to the stromal bed for 1 minute. The uncorrected and best-corrected visual acuities, refraction, and complications were assessed.

RESULTS:

The average follow-up was 16.27 ± 8.38 months (range, 6-30.5 months). The spherical equivalent decreased from -3.95 ± 4.11 to -1.07 ± 1.45 diopters (D) postoperatively (P < 0.001). The mean preoperative astigmatism was 4.42 ± 1.69 D (range, 1.00-7.25 D); however, surgical correction was limited to 6.00 D. Vector analysis of astigmatic correction showed an index of success of 55%. At the last follow-up, 41.7% (n = 15) and 61.1% (n = 22) of the eyes were within ±0.50 and ±1.00 D of emmetropia, respectively. Nineteen eyes (52.8%) achieved an uncorrected visual acuity of 20/40 or better. The best-corrected visual acuity remained within 1 line of the preoperative values in 26 cases (72.2%), improved in 8 (22.2%), and decreased in 2 (5.6%). Endothelial cell decompensation was observed in 1 eye (2.8%) 11 months postoperatively, and haze developed in 3 cases (8.3%).

CONCLUSIONS:

PRK-MMC may be an option to correct refractive errors after keratoplasty. A low preoperative endothelial cell count and haze may affect the safety outcomes.

• Authors: Adriana dos Santos Forseto, Junia Cabral Marques, Walton Nosé
• Journal: Cornea (Cornea) Vol. 29 Issue 10 Pg. 1103-8 (Oct 2010) ISSN: 1536-4798 [Electronic] United States
• PMID: 20628299 (Publication Type: Journal Article)

Chemical References

• Mitomycin

Topics

• Adolescent
• Adult
• Aged
• Combined Modality Therapy
• Corneal Transplantation
• Follow-Up Studies
• Humans
• Intraoperative Complications
• Keratoplasty, Penetrating
• Middle Aged
• Mitomycin (administration & dosage)
• Photorefractive Keratectomy
• Postoperative Complications
• Prospective Studies
• Refraction, Ocular (physiology)
• Refractive Errors (etiology, physiopathology, therapy)
• Treatment Outcome
• Visual Acuity (physiology)
• Young Adult