Prophylactic, therapeutic use of mitomycin-C considered safe

After reviewing more than 28 papersfrom the literature, Dr. Schallhorn noteda trend toward lower and lower dosing,referring to duration and concentration.

“Use of mitomycin (in refractive surgery)has gone from topically applied drops usedfor days or weeks down to low concentrationsof mitomycin applied for just a fewseconds,”Dr. Schallhorn said. “That is certainlythe trend in the literature, anecdotallyand clinically.”

In this non-comparative, non-randomizedretrospective study, 35 eyes of 30 patientswho had undergone PRK and developedsignificant haze (grade 3 or 4) and regressionhad significant improvement inhaze and best spectacle-corrected visualacuity (BSCVA) after the 2-minute application.The majority of eyes (31) had significantimprovement with a haze gradeless than 1 and only two eyes still experiencedhaze that required re-treatment ofscraping and MMC application. The follow-up was 12 months.

Prophylactic MMC use

MMC used prophylactically after PRK wasreported to be safe and effective in eyeswith high myopia, according to a prospective,double-masked, randomized clinicaltrial published last year (Ophthalmology2005;112:208-218;discussion 219).Researchers from the University ofPadova, Padova, Italy, randomly assignedintraoperative MMC 0.02% application toone eye and fluorometholone (FML) tothe other eye of 36 patients who underwentPRK for correction of > 7 D of myopia.At a mean follow-up of 18 months,there were no toxic effects.