Topical mitomycin-C for subepithelial fibrosis after refractive corneal surgery

Objective: To determine the effectiveness of mitomycin-C (MMC), 0.02%, in preventing recurrence of corneal subepithelial fibrosis after debridement and/or keratectomy in patients who have undergone refractive corneal surgery. Design: Noncomparative case series. Participants: Eight eyes of five patients with corneal subepithelial fibrosis who had previously undergone radial keratotomy (n = 4) or photorefractive keratectomy (n = 4). Intervention: All eyes underwent epithelial debridement followed by a single intraoperative application of MMC (0.02 %) for 2 minutes followed by saline irrigation. The eyes were then patched, or a bandage contact lens placed until epithelial healing was complete. Main Outcome Measures: Corneal clarity and best-corrected visual acuity (BCVA). Results: In all cases, the cornea remained clear with no recurrence throughout the follow-up period (6-25 mos., mean, 13.8 mos), No adverse reactions were report ed. BCVA improved in all cases. Conclusions: Subepithelial fibrosis can be a visually disabling condition after refractive corneal surgery. Topical application of MMC (0.02%) may be a successful method of preventing recurrence of subepithelial fibrosis after debridement, Ophthalmology 2000;107:89-94 (C) 2000 by the American Academy of Ophthalmology.