Effect of intraoperative mitomycin-C on healthy corneal endothelium after laser-assisted subepithelial keratectomy.

PURPOSE: To evaluate the effect of mitomycin-C (MMC) on corneal endothelial cells after laser-assisted subepithelial keratectomy (LASEK).

SETTING

Department of Ophthalmology, Changzheng Hospital, Shanghai, China.

METHODS

One hundred seventy-four eyes of 89 patients who did not previously wear contact lenses were treated with LASEK with intraoperative use of topical MMC 0.02% (15 seconds). Noncontact corneal specular microscopy was performed in all eyes preoperatively and 1, 3, and 6 months after surgery. Preoperative pachymetry and ablation depth were measured in all eyes. Repeated-measures analysis of variance was used to compare the changes in the endothelial central cell density (CCD), coefficient of variation in cell size (CV), and percentage of hexagram cells (HEX) over time. Linear regression analysis was conducted to analyze the correlation between the change in the 3 corneal endothelium indices over time and the ablation depth and residual stroma bed (RSB) thickness.

RESULTS

Preoperatively, the mean CCD was 2755 cells/mm(2)+/-373 (SD), the mean CV was 31.45+/-8.26, and the mean HEX was 66.03%+/-25.83%. After LASEK, there were no statistically significant changes in CCD, CV, or HEX (P>.05). Multiple linear regression did not identify ablation depth or RSB thickness as being predictive of a change in CCD, CV, or HEX (P>.05).

CONCLUSION

The use of intraoperative topical MMC 0.02% for 15 seconds after LASEK did not affect the corneal endothelium.