Photorefractive Keratectomy in High Myopic Defects with or without Intraoperative Mitomycin C: 1-Year Results

Purpose To study the results of the prophylactic use of mitomycin C (MMC) to reduce haze formation and refractive regression after excimer laser photorefractive keratectomy (PRK) for high myopic defects (>5 diopters). Methods Prospective, consecutive, observational study. A total of 124 eyes of 62 patients were divided into two groups of 31 patients, 62 eyes each (Groups A and B). Only Group A was treated with MMC 0.02%. The data of the two groups of eyes, related to the best-corrected visual acuity (BCVA), to the difference of refraction pre- and post-treatment, and to the corneal haze, were analyzed through combined permutation tests by using the NPC Test software. Results BCVA of Group A, 1 year after treatment, was better than that of the control Group B (one-sided p value = 0.013): Group A – 3 eyes (4.8%) had a loss of a decimal fraction and no eyes > 1; Group B – 13 eyes (20.9%) had a loss of a decimal fraction and 1 eye (1.6%) of 2. There was a smaller difference between attempted and achieved SE correction in Group A with respect to Group B (one-sided p value = 0.068): Group A – 43 eyes (69.3%) within ± 0.50 D; Group B – 31 eyes (50%) within ± 0.50 D. there was a smaller incidence of corneal haze in the group for which MMC was used (one-sided p value = 0.005). Conclusions In this study, the application of MMC 0.02% solution immediately after PRK produced lower haze rates and had better predictability and improved efficacy 1 year after treatment.