Haze after repeated use of mitomycin C

Poster Details

First Author: M.García González SPAIN

Co Author(s):    C. Giménez Vallejo    J. Paz   P. Drake    M. Teus     

Abstract Details

Purpose:

Through this case report we suggest that the use of intraoperative mitomycin C in LASEK (Laser Assisted subepithelial Keratomileusis) does not suppress the activity of the keratocytes.

Setting:

Vissum Santa Hortensia. Madrid, Espańa.

Methods:

Patient of 37 years old with no history of eye disease and a refraction of -4.00 sph -0.5 cyl 180ŗ in the right eye and -3.50 sph -0.75 cyl 20° in the left eye. A LASEK surgery was performed with intraoperative use of topical mitomycin-C 0.02% during 40 seconds in both eyes. Three months later the patient had a residual refraction of -0.50 sph -0.50 cyl at 20 ° in the left eye, showing a clear cornea without alterations. LASEK was performed again with intraoperative application of mitomycin C during 2 minutes. After 3 weeks the patient came to our clinic presenting a corneal ulcer because a nail trauma. 72 hours later the wound was closed but began to develop a subepithelial haze that lasted for more than 3 months, so we performed a new intervention to remove the haze.

Results:

After two treatments with mitomycin C, this patient maintained the capacity of keratocyte reactivation and transformation in fibroblasts and contractiles myofibroblasts which produce disorganized collagen causing haze after trauma.

Conclusions:

There is much controversy about the decreased number of keratocytes and their functioning caused by the application of mitomycin during surgery. In our patient the regenerative function of the cornea remained after the use of mitomycin C. This case suggests that perhaps the use of mitomycin should not be limited to cases of high risk of haze production but must be used prophylactically in all cases of surface refractive surgery without waiting for the appearance of haze, especially because mitomycin is more effective in blocking the replication of fibroblasts and their differentiation into myofibroblasts than removing the cells already formed. FINANCIAL DISCLOSURE?: No