Abstract

SO.06.02

Mitomycin C in therapeutic excimer laser treatment: Selected cases and review of literature

Linke S. J.^1,2, Klemm M.¹, Haberland P.², Richard G.¹, Katz T.^1,2
1Zentrum für Refraktive Chirurgie, Klinik- und Poliklinik für Augenheilkunde des Universitätsklinikums Eppendorf, Hamburg, ²CareVision Medical Services

Objective: To report a number (n=5) of excimer laser phototherapeutic keratectomies (PTK) for different corneal pathologies with a single intraoperative application of adjunctive topical 0.02% mitomycin C (MMC).
Methods: Interventional case reports and review of the literature. The excimer laser (Allegretto; Wavelight, Erlangen) was set for a 7-mm circular optical zone, which correlates to 8,9 mm treatment zone. The ablation depth varied between 20 µm and 130µm. In Salzmann Nodular Degeneration the treatment was preceded by a superficial keratectomy with a blade. Best corrected visual acuity (BCVA) was determined pre- and up to 9 months post laser treatment. Additionaly in vivo confocal microscopy (HRT II Rostock Cornea Modul) and corneal topography (Orbscan II; Bausch & Lomb) were performed.
Results: Best corrected visual acuity and subjective satisfaction improved in all of the cases. 9 months post surgery no recurrence of disease was observed and the corneae remained clear. Healing time of epithelial defects in MMC treated corneas were within normal range (<4 days post treatment) and toxic MMC related side effects (corneal or scleral melting, limbal stem cell insufficiency) did not appear in the 9 month follow-up.
Conclusions: The use of topical MMC in conjunction with PTK may be a safe and effective treatment of recurrent corneal pathologies (Granular corneal dystrophy, Salzmann nodular Degeneration, recurrent corneal scar after pterygium surgery). Confocal microscopy is a useful tool for planning surgical strategy and to reveal subtle changes of recurrent disease after Excimer laser treatment.

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