THE EFFECT OF MITOMYCIN-C ON CORNEAL ENDOTHELIAL CELL COUNT AFTER PHOTOREFRACTIVE KERATECTOMY

Abstract

Purpose: The goal of the study is to assess changes in central corneal endothelial cell density after photorefractive keratectomy (PRK) with mitomycin-C (MMC) 0.02% in patients with myopia.

Methods: This case control study included 66 eyes of 33 patients (22 cases&11 controls), aged 18 to 40 years. All were myopic (spherical equivalent refractive error -3.00 to -10.00D), who had photorefractive keratectomy (PRK). The treatment group was exposed to single intraoperative application of MMC 0.02% for 50 seconds while; the control group had the surgery without the use of MMC.  Specular microscopic assessment was done preoperatively and repeated 2 weeks, 1 month and 3 months after surgery for each eye to set changes in central corneal endothelial cell density (ECD) and coefficient of variation in cell size (CV).

Results: Forty-four eyes of 22 cases with mean age of 27.5±6.16,  range 18 to 40 years) and twenty-two eyes of 11 control patients with mean age of 25.4±5 years (range 19 to 34 years) underwent photorefractive keratectomy. Mean preoperative spherical equivalent refractive error was −6.2±1 (range −3.00 to −10.00). Three months after the operation the mean ECD was reduced significantly by 6.8% (p<0.05) from 2702.09 cells/mm² preoperatively to 2517.41cells/mm² for right eye and 5.4%(p<0.05) from 2687 cells/mm² to 2543 cells/mm² for the left eye in the treatment group whereas, the control group showed slight reduction in ECD (3%) from 2713 cells/mm² to 2630 cells/mm² (p= 0.32). There was no significant change in coefficient of variation in cell size (CV), (P=0.52) at 3 months.

Conclusion: Application of MMC 0.02% for 50 seconds during PRK in patients with myopia significantly affects central corneal endothelial cell density after three months follow up period.

Key words: photorefractive keratectomy, endothelial cell, Mitomycin-C, Myopia