Abstract

The aim of the present study was to determine the effect of different concentrations of mitomycin C (MMC) administered intraoperatively during laser-assisted subepithelial keratectomy (LASEK) surgery. A total of 261 patients (496 eyes) were randomly divided into two groups: 0.04% MMC treatment group consisting of 133 patients (245 eyes) and the 0.02% MMC treatment group consisting of 128 patients (251 eyes). The MMC solutions were dropped intraoperatively onto the ablation region and the duration was dependent on the preoperative refractive power of the patient’s cornea: ≤−3.00 diopters (D), 30 sec; between −3.25 D and −6.00 D, 60 sec; between −6.25 D and −9.00 D, 90 sec and ≥−9.25 D, 110 sec. Postoperative observations included haze formation, visual acuity, changes in refractive power, corneal endothelial cell density and incidence of complications. The one year postoperative incidence of haze differed significantly between the groups (P<0.05). The one week and one year comparisons of postoperative visual acuity also differed significantly between the groups (P<0.05). Postoperative changes in corneal refractive power at one, six and 12 months following surgery significantly differed between the groups (P<0.05). No statistically significant difference was identified between the density of corneal endothelial cells prior to surgery and the density at one, six and 12 months following surgery (P>0.05). Thus, the intraoperative application of 0.04% MMC solution effectively inhibited haze formation and markedly improved the efficacy of LASEK surgery, when compared with that of 0.02% MMC.

Highlights

  • Laser‐assisted subepithelial keratectomy (LASEK) surgery was introduced in 1999 to eliminate the flap‐related complications of laser-assisted in situ keratomileusis (LASIK) surgery

  • The LASEK surgical procedure reduces significant postoperative pain, corneal haze and prevents the flap and interface‐related problems associated with LASIK surgery [1]

  • The present study investigated the postoperative effects of administering different concentrations of mitomycin C (MMC) during LASEK surgery

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Summary

Introduction

Laser‐assisted subepithelial keratectomy (LASEK) surgery was introduced in 1999 to eliminate the flap‐related complications of laser-assisted in situ keratomileusis (LASIK) surgery. The LASEK surgical procedure reduces significant postoperative pain, corneal haze and prevents the flap and interface‐related problems associated with LASIK surgery [1]. LASEK surgery increases visual acuity and decreases aberrations and other defects [2]. Patients undergoing LASEK surgery reportedly have reduced risks of postoperative ectasia, indicating that this surface treatment may be safer, when the patients are highly myopic or have thin corneas. Other complications remain, including haze and regression, which limit the development of LASEK surgery. The present study investigated the postoperative effects of administering different concentrations of mitomycin C (MMC) during LASEK surgery

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