The Effect of Mitomycin-C on Corneal Endothelial Cells after Photorefractive Keratectomy

PURPOSE To evaluate short-term changes in central corneal endothelial cell density and morphology after photorefractive keratectomy (PRK) with mitomycin-C (MMC) 0.02% in patients with moderate myopia. METHODS In this prospective interventional case series, patients with moderate myopia (spherical equivalent refractive error from -4.0 to -8.0 D) underwent PRK with a single intraoperative application of MMC 0.02% for 40 seconds. Specular microscopy was performed preoperatively and repeated 6 months after surgery to determine changes in central corneal endothelial cell density (ECD), mean cell area (MCA) and coefficient of variation in cell size (CV). RESULTS Overall, 42 eyes of 21 participants with mean age of 26.2±6.3 years underwent surgery. Mean preoperative spherical equivalent refractive error was -5.2±1.2 D which was reduced to -0.4±0.5 D postoperatively (P < 0.001). Mean ECD was reduced insignificantly from 2,920±363 cells/mm(2) preoperatively to 2,802±339 cells/mm(2) postoperatively (P = 0.59). Similarly, there was no significant change in MCA or CV at six months (P = 0.76 and 0.52, respectively). CONCLUSION Application of MMC 0.02% for 40 seconds during PRK in patients with moderate myopia did not significantly affect central corneal endothelial cell density and morphology after a 6 month follow up period.