J Korean Ophthalmol Soc.  2015 Jul;56(7):992-997. 10.3341/jkos.2015.56.7.992.

Surface Ablation with 0.02% Mitomycin C for Retreatment after LASIK and LASEK

• Kim KY
• Kim HS
• Jung JW
• Lee HK
• Seo KY
• Kim EK
• Kim TI

• KMID: 2148797
• DOI: http://doi.org/10.3341/jkos.2015.56.7.992

Abstract

PURPOSE
To evaluate the efficacy and safety of surface ablation with mitomycin C (MMC) for the retreatment of refractive errors following laser-assisted in-situ keratomileusis (LASIK) and laser-assisted sub-epithelial keratectomy (LASEK).
METHODS
In this retrospective clinical study conducted at a single center, we evaluated 23 eyes that received surface ablation with MMC (0.02%, 20 seconds) between 2009 and 2013 for the treatment of residual refractive errors following myopic LASIK and LASEK. All eyes were evaluated for corneal thickness, initial refractive error, time interval to retreatment, amount of retreatment, duration of postoperative topical steroids use as well as uncorrected vision, spherical equivalent and corneal haziness preoperatively and 1, 3, 6 and 12 months postoperatively.
RESULTS
Initially corrected myopia in the LASIK group was -6.47 +/- 2.17 D and -5.68 +/- 2.51 D in the LASEK group. Mean time between initial and retreatment by surface ablation was 11.88 +/- 5.59 months for LASIK and 14.07 +/- 10.10 for LASEK. Retreat amount was 1.49 +/- 0.36 D after LASIK and -1.65 +/- 0.41 D after LASEK. At postoperative 12 months, uncorrected visions were -0.061 +/- 0.886 (log MAR) in the LASIK group and -0.004 +/- 0.745 (log MAR) in the LASEK group and spherical equivalents were -0.55 +/- 0.56 D in the LASIK group and 0.36 +/- 0.33 D in the LASEK group. Postoperative hazes developed in 1 of 8 LASIK eyes and 3 of 15 LASEK eyes which resolved with application of topical steroid for 2-3 months postoperatively.
CONCLUSIONS
Surface ablation with 0.02% MMC is safe and highly effective for treating myopic regression following LASIK or LASEK. Application of 0.02% MMC for 20 seconds was effective in preventing postoperative haze formation and maintaining stable vision and spherical equivalent at 12 months after retreatment.

Keyword

LASEK; LASIK; Mitomycin C; Retreatment; Surface ablation

MeSH Terms

Keratectomy, Subepithelial, Laser-Assisted*
Keratomileusis, Laser In Situ*
Mitomycin*
Myopia
Refractive Errors
Retreatment*
Retrospective Studies
Steroids
Mitomycin
Steroids

Reference

References

1. Duffey RJ, Leaming D. U.S. trends in refractive surgery: 2001 International Society of Refractive Surgery survey. J Refract Surg. 2002; 18:185–8.

2. Duffey RJ, Leaming D. US trends in refractive surgery: 2002 ISRS survey. J Refract Surg. 2003; 19:357–63.

3. Bailey MD, Zadnik K. Outcomes of LASIK for myopia with FDA-approved lasers. Cornea. 2007; 26:246–54.

4. Schallhorn SC, Farjo AA, Huang D. . Wavefront-guided LASIK for the correction of primary myopia and astigmatism a re-port by the American Academy of Ophthalmology. Ophthalmol-ogy. 2008; 115:1249–61.

5. Hersh PS, Fry KL, Bishop DS. Incidence and associations of re-treatment after LASIK. Ophthalmology. 2003; 110:748–54.

6. Bragheeth MA, Fares U, Dua HS. Re-treatment after laser in situ keratomileusis for correction of myopia and myopic astigmatism. Br J Ophthalmol. 2008; 92:1506–10.

7. Chen YI, Chien KL, Wang IJ. . An interval-censored model for predicting myopic regression after laser in situ keratomileusis. Invest Ophthalmol Vis Sci. 2007; 48:3516–23.

8. Lyle WA, Jin GJ. Retreatment after initial laser in situ keratomileusis. J Cataract Refract Surg. 2000; 26:650–9.

9. Randleman JB, Loft ES, Banning CS. . Outcomes of wave-front-optimized surface ablation. Ophthalmology. 2007; 114:983–8.

10. Shojaei A, Mohammad-Rabei H, Eslani M. . Long-term evalu-ation of complications and results of photorefractive keratectomy in myopia: an 8-year follow-up. Cornea. 2009; 28:304–10.

11. Gartry DS, Larkin DF, Hill AR. . Retreatment for significant regression after excimer laser photorefractive keratectomy A pro-spective, randomized, masked trial. Ophthalmology. 1998; 105:131–41.

12. Mulhern MG, Condon PI, O'Keefe M. Myopic and hyperopic laser in situ keratomileusis retreatments: indications, techniques, limi-tations, and results. J Cataract Refract Surg. 2001; 27:1278–87.

13. Domniz Y, Comaish IF, Lawless MA. . Recutting the cornea versus lifting the flap: comparison of two enhancement techniques following laser in situ keratomileusis. J Refract Surg. 2001; 17:505–10.

14. Rubinfeld RS, Hardten DR, Donnenfeld ED. . To lift or recut: changing trends in LASIK enhancement. J Cataract Refract Surg. 2003; 29:2306–17.

15. Caster AI, Friess DW, Schwendeman FJ. Incidence of epithelial in-growth in primary and retreatment laser in situ keratomileusis. J Cataract Refract Surg. 2010; 36:97–101.

16. Pérez-Santonja JJ, Ayala MJ, Sakla HF. . Retreatment after la-ser in situ keratomileusis. Ophthalmology. 1999; 106:21–8.

17. Carones F, Vigo L, Carones AV, Brancato R. Evaluation of photo-refractive keratectomy retreatments after regressed myopic laser in situ keratomileusis. Ophthalmology. 2001; 108:1732–7.

18. Amoils SP. Photorefractive keratectomy using a scanning-slit la-ser, rotary epithelial brush, and chilled balanced salt solution. J Cataract Refract Surg. 2000; 26:1596–604.

19. Nassiri N, Sheibani K, Safi S. . Alcohol-assisted debridement in PRK with intraoperative mitomycin C. Optom Vis Sci. 2014; 91:1084–8.

20. Srinivasan S, Drake A, Herzig S. Photorefractive keratectomy with 0.02% mitomycin C for treatment of residual refractive errors after LASIK. J Refract Surg. 2008; 24:S64–7.

21. Hanna KD, Pouliquen YM, Waring GO 3rd. . Corneal wound healing in monkeys after repeated excimer laser photorefractive keratectomy. Arch Ophthalmol. 1992; 110:1286–91.

22. Beerthuizen JJ, Siebelt E. Surface ablation after laser in situ kerato-mileusis: retreatment on the flap. J Cataract Refract Surg. 2007; 33:1376–80.

23. Chen MH, Tong X, Sun J. The proportional odds model for multi-variate interval-censored failure time data. Stat Med. 2007; 26:5147–61.

24. McAlinden C, Moore J. Laser-assisted subepithelial keratectomy retreatment surgery. J Cataract Refract Surg. 2011; 37:358–63.

25. Liu A, Manche EE. Visually significant haze after retreatment with photorefractive keratectomy with mitomycin-C following laser in situ keratomileusis. J Cataract Refract Surg. 2010; 36:1599–601.

26. Sadeghi HM, Seitz B, Hayashi S. . In vitro effects of mitomy-cin-C on human keratocytes. J Refract Surg. 1998; 14:534–40.

27. Schipper I, Suppelt C, Gebbers JO. Mitomycin C reduces scar for-mation after excimer laser (193 nm) photorefractive keratectomy in rabbits. Eye (Lond). 1997; 11:649–55.

28. Majmudar PA, Forstot SL, Dennis RF. . Topical mitomycin-C for subepithelial fibrosis after refractive corneal surgery. Ophthalmology. 2000; 107:89–94.

29. Maldonado MJ.Intraoperative MMC after excimer laser surgery for myopia. Ophthalmology. 2002; 109(826):author reply. 826–8.

30. Gambato C, Ghirlando A, Moretto E. . Mitomycin C modu-lation of corneal wound healing after photorefractive keratectomy in highly myopic eyes Ophthalmology. 2005; (112):208–18. dis-cussion 219.

31. Ng-Darjuan MF, Evangelista RP, Agahan AL. Photorefractive ker-atectomy with adjunctive mitomycin C for residual error after la-ser-assisted in situ keratomileusis using the pulzar 213 nm sol-id-state laser: early results. ISRN Ophthalmol. 2013; 2013–815840.

32. Neira-Zalentein W, Moilanen JA, Tuisku IS. . Photorefractive keratectomy retreatment after LASIK. J Refract Surg. 2008; 24:710–2.