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Less invasive alternatives to penetrating corneal grafts available
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NUREMBERG, Germany — Combining mitomycin-C with phototherapeutic keratectomy may work well as a less invasive alternative to penetrating corneal graft, a group of surgeons reported here.
In a retrospective study, Rudolf Autrata, CSc, studied 61 eyes that underwent phototherapeutic keratectomy without mitomycin-C (MMC) and 47 eyes that underwent the same procedure with MMC. Dr. Autrata said 23 eyes were pediatric, and patients were being treated for primary or recurrent anterior corneal dystrophy to improve VA and to delay or postpone corneal grafting.
After phototherapeutic keratectomy, MMC 0.02% was applied to the stroma, Dr. Autrata wrote in a poster presentation at the German Ophthalmic Surgeons conference. Follow-up ranged from 3 to 11 years.
Patients in the group without MMC treatment improved from 6/37.5 at baseline to 6/15 at the final follow-up. Those who had MMC treatment had a visual acuity improvement from 6/41 preop to 6/9.6 at the last follow-up.
Mean time to significant recurrence was 38.4 months for the group who did not receive adjunctive MMC and 53.6 months for the group that did.
“The use of topical MMC following phototherapeutic keratectomy may be safe and effective adjunctive treatment and may be helpful in preventing recurrence of anterior corneal dystrophies,” Dr. Autrata said.
The treatment still needs long-term results because there are potential long-term adverse events, he added.