The Effects of Mitomycin C on Tear Function After Photorefractive Keratectomy: A Contralateral Comparative Study

Journal of refractive surgery (Thorofare, N.J.: 1995) (Impact Factor: 3.47). 04/2013; 29(4):260-4. DOI: 10.3928/1081597X-20130318-05
Source: PubMed


To assess the effects of adjuvant mitomycin C (MMC) on tear function tests after photorefractive keratectomy (PRK) for myopia.
In this prospective, randomized, double-blind study, one eye of myopic patients undergoing PRK was randomly chosen for PRK and the other eye was treated with PRK plus the application of 0.02% MMC for 20 seconds onto the ablated stroma. All patients had corneal esthesiometry, fluorescein break-up time testing, fluorescein and Rose Bengal staining, and Schirmer testing with anesthesia, and they also completed a questionnaire preoperatively and at 1.5, 3, 6, and 12 months after surgery.
Twenty-seven patients with a mean age of 25 ± 3.27 years were enrolled. There were no statistically significant differences between the PRK and PRK+MMC groups regarding the symptoms and tear function tests preoperatively or at any postoperative follow-up visit. Preoperative and postoperative results in the total sample were also compared; statistically significantly different results were observed in fluorescein break-up time and dry eye symptoms at 1.5 months, which showed improvement thereafter. Corneal sensation was significantly lower at all postoperative follow-up visits compared with preoperative results.
The intraoperative use of MMC during PRK did not induce tear deficiency, and it seems that MMC can be used safely when necessary.[J Refract Surg. 2013;29(4):260-264.].

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    ABSTRACT: La queratectomía fotorrefractiva (PRK) remodela el estroma de la córnea para compensar los errores refractivos. La eliminación del epitelio y la ablación del estroma provoca la alteración de los nervios corneales y la liberación de diversos péptidos de la lágrima, epitelio, estroma y nervios. Innumerables citoquinas, factores de crecimiento y metaloproteasas de la matriz participan en el proceso de regeneración y cicatrización corneal. Su equilibrio determinará si la re-epitelización y la remodelación del estroma son adecuados. El objetivo final es el logro de la transparencia corneal para restablecer la función de la córnea, así como la calidad visual adecuada. Por tanto, la respuesta de regeneración y cicatrización corneal es esencial para el éxito de la cirugía refractiva. Nuestro objetivo es aportar una visión general sobre el modo en que se desarrolla dicho proceso tras la PRK. Revisaremos también la influencia de la aplicación intraoperatoria de mitomicina C, lentes de contacto terapéuticas, y otros fármacos para prevenir el haze y el dolor tras la PRK.
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    ABSTRACT: Photorefractive keratectomy (PRK) remodels corneal stroma to compensate refractive errors. The removal of epithelium and the ablation of stroma provoke the disruption of corneal nerves and a release of several peptides from tears, epithelium, stroma and nerves. A myriad of cytokines, growth factors, matrix metalloproteases participate in the process of corneal wound healing. Their balance will determine if reepithelization and stromal remodeling are appropriate. The final outcome is to achieve corneal transparency for restoring corneal function, and a proper visual quality. Therefore, wound-healing response is critical for a successful refractive surgery. Our goal is to provide an overview into how corneal wounding develops following PRK. We will also review the influence of intraoperative application of mitomycin C, bandage contact lenses, anti-inflammatory and other drugs in preventing corneal haze and post-PRK pain.
    Journal of Optometry 10/2014; DOI:10.1016/j.optom.
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    ABSTRACT: AIM: To observe the early tear film changes after trabeculectomy using Keratograph 5M. METHODS: Fourty-one patients (46 eyes) of glaucoma who underwent trabeculectomy were involved. First tear break up time (FTBUT), average tear break up time (ATBUT), non-invasive tear meniscus height (NITMH), lipid layer thickness and meibomian gland scores were measured at 1d preoperatively and at 1d, 1wk, 1mo postoperatively. RESULTS: At 1d, 1wk and 1mo postoperatively, FTBUT and ATBUT decreased greatly (P<0.05), as well as lipid layer thickness (P<0.017). NITMH at 1d postoperatively increased significantly, but at 1wk and 1mo postoperatively decreased greatly (P<0.05). There was no significantly difference in meibomian gland scores between preoperation and postoperation (P>0.05). CONCLUSION: Keratograph 5M could be used to evaluate tear film function rapidly and accurately. Trabeculectomy significantly alters tear film stability and tear secretion in the short term after operation.

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