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