EC Ophthalmology

Research Article Volume 14 Issue 2 - 2023

How does Mitomycin C Affect the Posterior Stromal Keratocyte Density After Photorefractive Keratectomy? Science Helping to Facilitate Public Health Costs in Ophthalmology

Kianoush Shahraki, Alireza Ansari Moghaddam, Hanie Ahmadi, Paria Ghasemi Boroumand, Kourosh Shahraki* and Masoumeh Shahdadi

Eye Research Center, Alzahra Eye Hospital, Zahedan, Iran

*Corresponding Author: Kourosh Shahraki, Eye Research Center, Alzahra Eye Hospital, Zahedan, Iran.
Received: January 19, 2023; Published: January 28, 2023



Background: Mitomycin C is used to prevent corneal opacity. The present study seeks to investigate the influence of Mitomycin C on the number of Keratocyst in the posterior layer of corneal stroma after photorefractive keratectomy (PRK).

Materials and Methodology: The cohort method was utilized to conduct this study. 26 eyes among those resorting to the eye hospital of Al-Zahra in Zahedan were selected and convenient sampling was carried out among those patients who had undergone photorefractive keratectomy (PRK). The number of Keratocyst layers in the posterior corneal layer of the patients was counted before the operation and three months after that. Student T-test was utilized to analyze the data.

Results: Before the operation, the average spherical equivalent of refractive errors was -3.6 ± 15.6µ and the average corneal thickness of the patient was 538 ± 41.2µ with the average depth of corneal removal being 74.7 ± 15.6µ. The average number of the Keratocysts in the posterior layer of corneal stroma before and three months after the operation were 714.6 ± 12.1 and 714.7 ± 12.9 respectively. No significant difference was observed between the number of Keratocysts before and after the operation (p = 0.838).

Conclusion: Using Mitomycin 0.02 C for 20 seconds during RPK in patients suffering from low myopia does not result in statistically significant changes in the number of Keratocysts in the posterior corneal layer in the 3-month follow up. Thus, it doesn’t seem necessary to impose Mitomycin C to patient’s costs of surgery.

Keywords: Photorefractive Keratectomy; Mitomycin C; Confoscan III

  1. Zeng L., et al. “Multiple phototherapeutic keratectomy treatments in a Chinese pedigree with corneal dystrophy and an R124L mutation: a 20-year observational study”. BMC Ophthalmology1 (2019): 191.
  2. Saika S., et al. “Modulation of Smad signaling by non-TGFβ components in myofibroblast generation during wound healing in corneal stroma”. Experimental Eye Research 142 (2016): 40-48.
  3. Carones F., et al. “Evaluation of the prophylactic use of mitomycin-C to inhibit haze formation after photorefractive keratectomy”. Journal of Cataract and Refractive Surgery12 (2002): 2088-2095.
  4. Kim TI., et al. “Mitomycin C induces apoptosis in cultured corneal fibroblasts derived from type II granular corneal dystrophy corneas”. Molecular Vision 14 (2008): 1222-1228.
  5. Carlos de Oliveira R and Wilson SE. “Biological effects of mitomycin C on late corneal haze stromal fibrosis following PRK”. Experimental Eye Research 200 (2020): 108218.
  6. Hwang S and Choi S. “A Comparative Study of Topical Mitomycin C, Cyclosporine, and Bevacizumab after Primary Pterygium Surgery”. Korean Journal of Ophthalmology6 (2015): 375-381.
  7. Mandour SS., et al. “Preoperative Versus Intraoperative Subpterygial Mitomycin C Injection for Prevention of Pterygium Recurrence”. Journal of Ocular Pharmacology and Therapeutics6 (2015): 340-343.
  8. Zhou M., et al. “Use of Mitomycin C to reduce the incidence of encapsulated cysts following Ahmed glaucoma valve implantation in refractory glaucoma patients: a new technique”. BMC Ophthalmology 14 (2014): 107.
  9. Bagheri A., et al. “Trichloroacetic acid 10% injection for treatment of conjunctival inclusion cysts”. Orbit2 (2020): 107-111.
  10. Shahraki K., et al. “Effects of intracameral cefuroxime on corneal endothelial cell counts and its morphology after cataract surgery”. Interventional Medicine and Applied Science2 (2017): 100-104.
  11. Gokhale NS. “Mitomycin C therapy for corneal intraepithelial neoplasia masquerading as limbal stem cell deficiency with recurrent epithelial defect”. International Ophthalmology2 (2011): 161-163.
  12. Wilson MW., et al. “Topical mitomycin C for the treatment of conjunctival and corneal epithelial dysplasia and neoplasia”. American Journal of Ophthalmology 124 (1997): 303-311.
  13. Majnudar PA., et al. “Topical mitomycin-C for subepithelial fibrosis after refractive corneal surgery”. Ophthalmology 107 (2000): 89-94.
  14. Shahraki K., et al. “Effects of Topical 1% Sodium Hyaluronate and Hydroxypropyl Methylcellulose in Treatment of Corneal Epithelial Defects”. Medical Hypothesis, Discovery and Innovation in Ophthalmology4 (2016): 136-144.
  15. Dougherty PJ., et al. “Corneoscleral melt after pterygium surgery using a single intraoperative application of mitomycin-C”. Cornea5 (1996): 537-540.
  16. Aghaei H and Shahraki K. “Isolated Cavernous Hemangioma of the Conjunctiva: Case Report and Review of Literature”. Iranian Journal of Ophthalmology4 (2013): 317-319.
  17. Pfister RR. “Permanent corneal edema resulting from the treatment of PTK corneal haze with mitomycin: a case report”. Cornea7 (2004): 744-777.
  18. Lee JS., et al. “Mitomycin C influence on inhibition of cellular proliferation and subsequent synthesis of type I collagen and laminin in primary and recurrent pterygia”. Ophthalmic Research3 (2001): 140-146.
  19. Cibis G W., et al. “American Academy of Ophthalmology section 2: Fundamentals and Principles of Ophthalmology; United State of America”. LEO 2015-2016 (2016): 45-49.
  20. Shirzadi K., et al. “Studying the Effect of Tropicamide Various Concentrations on Routine Dilation of the Pupil”. Biomedical and Pharmacology Journal2 (2015).
  21. Mirzaei M., et al. “Clinical and Topographical Corneal Changes after Keraring Implantation in Keratoconus Patients”. Advances in Bioscience and Clinical Medicine1 (2015): 40-45.
  22. Kocabeyoglu S., et al. “In Vivo Confocal Microscopic Evaluation of Corneas in Patients with Exfoliation Syndrome”. Journal of Glaucoma2 (2016): 193-197.
  23. Shirzadi K., et al. “Comparison of Manual Refraction Versus Autorefraction in 60 Diabetic Retinopathy Patients”. Medical Archives4 (2016): 280-283.
  24. Lee JS., et al. “Mitomycin C influence on inhibition of cellular proliferation and subsequent synthesis of type I collagen and laminin in primary and recurrent pterygia”. Ophthalmic Research3 (2001): 140-146.
  25. Netto MV., et al. “Effect of prophylactic and therapeutic mitomycin C on corneal apoptosis, cellular proliferation, haze, and long-term keratocyte density in rabbits”. Journal of Refractive Surgery6 (2006): 562-574.
  26. Midena E., et al. “Long-term effects on corneal keratocytes of mitomycin C during photorefractive keratectomy: a randomized contralateral eye confocal microscopy study”. Journal of Refractive Surgery9 (2007): S1011-S1014.
  27. Ketbab Asadollah., et al. “Histopathologic changes caused by MMC in rabbits’ cornea”. Bina, Period1-50 (2007): 82-87.
  28. Goldsberry DH., et al. “Effect of mitomycin C on the corneal endothelium when used for corneal subepithelial haze prophylaxis following photorefractive keratectomy”. Journal of Refractive Surgery7 (2007): 724-727.
  29. Zar DT and Jain S. “Topical MM-C for subepithelial fibrosis after refractive corneal surgery”. Ophthalmology 108 (2001): 239-240.
  30. Aldwin HC and Marshall J. “Growth factors in corneal wound healing following refractive surgery: a review”. Acta Ophthalmologica Scandinavica 80 (2002): 238-247.
  31. Lia YH., et al. “Mitomycin-C alters corneal stromal non healing and corneal haze in rabbits after argon fluoride excimer laser photorefractive keratectomy”. Journal of Ocular Pharmacology and Therapeutics 20 (2004): 129-138.
  32. Wilson SE., et al. “The wound healing response after laser in situ keratomileusis and photorefractive keratectomy: elusive control of biological variability and effect on custom laser vision correction”. Archives of Ophthalmology 119 (2001): 889-889.

Kourosh Shahraki., et al. How does Mitomycin C Affect the Posterior Stromal Keratocyte Density After Photorefractive Keratectomy? Science Helping to Facilitate Public Health Costs in Ophthalmology. EC Ophthalmology 14.2 (2023): 13-21.