First Author: J.Garrido linares SPAIN
Co Author(s): J. Ramos Navarro
Purpose:
To assess the effect of MMC on the corneal endothelium in patients undergoing laser subepithelial keratomileusis (LASEK).
Setting:
: Clinica Baviera. Instituto Oftalmológico Europeo. Málaga, Spain.
Methods:
A prospective study of 64 eyes of 32 patients of whom 15 were men and 17 women. All eyes were treated by refractive surgery LASEK surface with an excimer laser Technolas Z-100.
The mean spherical equivalent treated was - 4.77 ± 1.5 diopters and average ablation 84 ± 27 microns.
After ablation, and prior to replenishment of the epithelium there was a single application of MMC 0.02% over a period of 15 seconds using a methylcellulose sponge. After washing with saline and replacement of the corneal epithelium, a contact lens was placed and removed between 5th and 7th day.
We use the endothelial specular microscope Topcon SP-3000 P, taking as value the average of three endothelial counts before surgery and 12 months after the surgery. The endothelial cell density, coefficient of variation and percentage of hexagonal cells were compared with non-parametric Mann Withney test.
Results:
The endothelial count before and after surgery was 2853 ± 783 céls/mm2 (range céls/mm2 1811-3012) and 2747 ± 588 céls/mm2 (range: 1540-3651 céls/mm2), respectively, with no statistically significant difference (P = 0.68). The coefficient of variation before and after surgery was 0.31 ± 0.07 (range: 0.22 to 0.48) and 0.26 ± 0.04 (range: 0.21 to 0.32), respectively. This difference was not statistically significant (P = 0.07). The percentage of hexagonal cells before and after surgery was 60% ± 6.8% (range 47% to 70%) and 65% ± 6.7% (range 52% to 73%), respectively. The difference was not statistically significant between groups (P = 0.12).
No patient developed haze after surgery
Conclusions:
In refractive surgery, the MMC is used on various occasions, controlling stromal sparring, prevents the formation of corneal haze.
Although, in addition to the direct damage that causes death by apoptosis after the application of MMC, some studies have shown that there is an accumulated DNA damage in endothelial cells, that in the short term does not cause the death of these cells, but it could be the cause of cell death in the long run, so more studies are needed to assess long-term the actual effects of MMC on the corneal endothelium.
Financial Disclosure:
No
