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Review
. 2009 Oct;25(10):894-7.
doi: 10.3928/1081597X-20090617-10. Epub 2009 Oct 12.

Impact on the corneal endothelium of mitomycin C during photorefractive keratectomy

Danny S Roh  1 , James L Funderburgh
Affiliations
Review

Impact on the corneal endothelium of mitomycin C during photorefractive keratectomy

Danny S Roh et al. J Refract Surg. 2009 Oct.

Abstract

Purpose: This brief review examines both basic science and clinical studies to evaluate the potential impact on the health of the corneal endothelium of mitomycin C (MMC) usage during photorefractive keratectomy (PRK).

Methods: The mechanism of action and consequences of MMC are reviewed within the context of in vitro, animal, and clinical studies and a hypothesis of how this vital cell layer responds to MMC at both the cellular and clinical levels is formed.

Results: Seven basic science studies were reviewed demonstrating significant MMC toxicity to corneal endothelial cells. Of the five clinical studies reviewed, three demonstrated no effect on corneal endothelial density, whereas two studies found significant cell loss after MMC usage.

Conclusions: Although all of the basic science studies reviewed highlight the toxicity of MMC on the corneal endothelium, current clinical studies are less conclusive. Given the corneal penetration of MMC and the fragile nature of the corneal endothelium, additional follow-up studies are needed to determine the long-term impact of MMC usage during PRK on the corneal endothelium.

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