Intraoperative Mitomycin-C for Severe Stromal Haze After Refractive Surgery

Abstract

Abstract: : Purpose:To determine the efficacy of Mitomycin-C (MMC) 0.025% in preventing stromal fibrosis after scar debridement in patients with recalcitrant stromal haze following refractive surgery Methods: Noncomparative case series of 11 eyes in 10 patients who had undergone previous refractive surgery and had developed severe stromal haze. Previous primary refractive surgery included photorefractive keratectomy (PRK) (6 eyes), Lasik (3 eyes) and radial keratotomy (2 eyes). A total of 19 repeat surgical procedures had been done to correct either residual refractive error or haze at the time of presentation. Surgical treatment consisted in epithelial debridement followed by mechanical and/or laser scar removal and intraoperative application of MMC 0.025%. Results: Best-corrected visual acuity (BCVA) improved in all patients. BCVA was calculated in logMAR units. Mean preoperative BCVA was 20/84 (range 20/30-20/200) while mean postoperative BCVA was 20/32 (range 20/20-20/100). The difference between pre and postoperative BCVA was statistically significant (p<0.05). All patients had clearer corneas and had no recurrence of haze throughout the follow-up period (6-18 months). No adverse reactions were noted. Conclusion:Topical intraoperative application of MMC 0.025% may be a successful adjunct to mechanical or laser scar removal in preventing recurrence of severe stromal haze and improve BCVA after complicated corneal refractive surgery.

Keywords: 545 refractive surgery: complications • 552 refractive surgery: PRK • 544 refractive surgery