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A. Laurenzi, M.R. Chalita, R.R. Krueger; Surface Ablation With Topical Mitomycin for High Myopia Correction . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2690.
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Purpose:Evaluate refractive outcome and haze incidence of surface ablation procedures (Laser Epithelial Keratomileusis-LASEK, and Photorefractive Keratectomy-PRK) with the use of topical mitomycin 0.02% intraoperatively for high myopia correction. Methods:Retrospective noncomparative single surgeon case series. Twenty-two eyes were evaluated ( 10 eyes had PRK and 12 eyes had LASEK). The surgical technique used in LASEK cases was an 8.0mm circular ring filled with 20% ethanol solution and applied on the cornea for 30 seconds. Laser ablation was performed using the Summit Autonomus LADARVision Excimer Laser. After laser ablation, a 8.0mm round sponge soaked with mitomycin 0.02% solution was applied on the stromal bed for 2 minutes and then removed. PRK procedures were done by removing the epithelium after applying 20% ethanol solution on the cornea for 30 seconds and laser ablation was performed using the same laser as for LASEK. Postoperatively, all patients received Fluorometholone 0.1% for 1 month. Corneal haze, BCVA, UCVA and manifest refraction were the parameters evaluated. Corneal haze was graded based on Fantes classification. Results: Of all primary treated eyes, the greatest haze grade found was 0.5 at the three month follow-up. Eyes that were previously treated and had haze, when retreated with combined use of mitomycin, showed significant improvement in haze grade and best corrected visual acuity. No complications due to mitomycin use were reported and no re-epithelization delay was noted. Conclusions: Surface laser correction, in spite of being safe and predictable, can lead to corneal haze, myopic regression, discomfort and delayed recovery. Topical mitomycin is a safe adjunct in eyes with high correction, preventing haze occurrence and consequent regression, and making surface treatments much more reliable.
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