Background: Photorefractive keratectomy (PRK) is a type of refractive surgery. Mitomycin C (MMC) is an anti-fibroblast agent isolated from cultures of Streptomyces caespitosus and has been used in ophthalmic surgeries such as pterygium excision and trabeculectomy for a long time. MMC usage in keratorefractive surgeries became widespread after revealing the fact that this agent can effectively reduce haze formation after surgery and hence improve the predictability of visual outcomes following refractive surgery.
Objective: To compare differences in the endothelial cell count before and after photorefractive keratectomy (PRK) for a moderate myopic eye with MMC (0.02%) applied with a soaked cellulose sponge intraoperatively over the central ablated corneal stroma for 60 seconds.
Patients and methods: In this study, 50 eyes of 25 patients attended the outpatient clinic of the Ophthalmology Department at El Fath Eye Hospital from July 2020 to January 2020, undergoing photorefractive keratectomy (PRK) with MMC 0.02% application for 60 seconds were enrolled in this study. Specular microscopy was performed preoperatively and repeated one month and 2 months after surgery.
Results: There was a statistically significant difference in error of refraction throughout study phases (preoperatively, one month postoperatively and two months postoperatively). There was a decrease in error of refraction one month postoperatively. The difference was statistically significant with improvement of 92.39%. Moreover, the improvement persisted at two months postoperatively with 11.48% improvement compared to its value at one month postoperatively. There was a statistically insignificant difference between right eyes and left eyes regarding vision refraction error, K-max, UCVA, coefficient of variation, central corneal thickness, hexagonally and PRK endothelial cell density (ECD) in preoperatively, one month and two months postoperatively (p>0.05).
Conclusion: No significant difference in corneal endothelial cell changes before and after one month and 2 months of PRK surgery with using of MMC.