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LASEK with MMC may spur temporary redistribution of stromal cell density
Am J Ophthalmol. 2012;153(1):17-23.
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Surface ablation with intraoperative mitomycin C did not cause permanent keratocyte depletion and led to an only temporary reorganization of cell density in the mid and deep stroma, a study found.
"Corneal cellularity tends to normalize over time, and 3 years postoperatively the mean cell density throughout the cornea seems to maintain normal values," the study authors said.
The prospective, non-randomized, interventional case series included 32 myopic eyes that underwent LASEK with 0.02% MMC. A control group comprised 32 healthy, untreated eyes.
A Schwind Esiris excimer laser with a photorefractive keratectomy nomogram was used to perform all ablations. A topical antibiotic, topical non-steroidal anti-inflammatory agent and bandage contact lens were applied after surgery. Thereafter, postoperative therapy included a topical antibiotic and tapered topical steroid.
Patients were evaluated postoperatively at 1 day, 1 week, 1 month, 3 months, 15 months and 3 years.
At 3 months postop, stromal bed density was 16,993 cells/mm3 in the study group and 29,660 cells/mm3 in the control group. Cell density in the mid-stroma was 30,783 cells/mm3 in the study group and 18,505 cells/mm3 in the controls. Cell density in the deep stroma was 30,268 cells/mm3 in the study group and 18,438 cells/mm3 in the controls. All three differences were statistically significant (P = .0001).
At 3 years, cell density in the stromal bed had changed insignificantly. However, cell density in the mid-stroma and deep stroma had diminished to levels similar to those of the control group, the authors said.