RESUMEN
PURPOSE: To evaluate the safety, efficacy, and stability of excimer laser photorefractive keratectomy (PRK) and mitomycin-C (MMC) 0.02% for consecutive hyperopia after radial keratotomy (RK). METHODS: A prospective, nonrandomized, noncomparative interventional case series of 35 eyes (22 patients) with consecutive hyperopia after RK. All eyes were treated with PRK, using a single intraoperative topical application of MMC 0.02% for 60 seconds. Uncorrected visual acuity, best spectacle-corrected visual acuity, refraction, slit-lamp evidence of corneal haze, and endothelial cell counts were evaluated for up to 18 months after surgery. RESULTS: Postoperative follow-up was 9.6 +/- 5.5 months (ranged from 3 to 18 months). The mean spherical equivalent was +3.36 +/- 1.94 diopters preoperatively and +0.27 +/- 1.38 diopters 12 months after surgery. The uncorrected visual acuity was > or =20/30 in 37.1% of the eyes at 1 month and 78.6% of the eyes at 12 months. At 12 months, 14% of the eyes lost up to 1 line of Snellen acuity in the best spectacle-corrected visual acuity. No corneal haze was observed and the endothelial cell counts remained unchanged postoperatively (P > 0.05). CONCLUSION: PRK with MMC 0.02% for consecutive hyperopia after RK seems to be a safe and effective procedure at least in the short-term period of 6 months.
Asunto(s)
Alquilantes/administración & dosificación , Hiperopía/tratamiento farmacológico , Hiperopía/cirugía , Queratotomía Radial/efectos adversos , Láseres de Excímeros/uso terapéutico , Mitomicina/administración & dosificación , Queratectomía Fotorrefractiva , Adulto , Recuento de Células , Terapia Combinada , Endotelio Corneal/patología , Femenino , Estudios de Seguimiento , Humanos , Hiperopía/etiología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Refracción Ocular/fisiología , Resultado del Tratamiento , Agudeza Visual/fisiologíaRESUMEN
A mitomicina C é um antimetabólito que atua em nível celular bloqueando a replicação de DNA e RNA e inibindo a síntese protéica. Utilizada em diversas áreas da oftalmologia, recentemente vem sendo empregada como moduladora da resposta cicatricial corneana em cirurgias ópticas/refrativas por "excimer laser". A aplicação única de mitomicina C associada à cirurgia fotoablativa de superfície corneana tem se mostrado opção segura e eficiente para fins terapêuticos em olhos com opacidade corneana pré-existente e/ou profiláticos em olhos com alto risco de desenvolvimento de opacificação corneana pós-operatória. O uso da droga em cirurgia fotoablativa deve ser cauteloso até que seguimento de longo prazo avalie sua inocuidade tardia. O presente texto faz revisão dos principais estudos sobre modulação da resposta cicatricial corneana com uso de mitomicina C em cirurgias ópticas/refrativas de superfície.
Asunto(s)
Humanos , Animales , Mitomicina/farmacología , Miopía/cirugía , Inhibidores de la Síntesis del Ácido Nucleico/farmacología , Queratectomía Fotorrefractiva , Cicatrización de Heridas/efectos de los fármacos , Córnea/efectos de los fármacos , Opacidad de la Córnea/prevención & control , Mitomicina/efectos adversos , Inhibidores de la Síntesis del Ácido Nucleico/efectos adversos , Agudeza VisualRESUMEN
Mitomycin C is an antimetabolite agent that blocks DNA and RNA replication and protein synthesis. It has been used in several ophthalmologic areas, and recently as a modulator of corneal wound healing in excimer laser surgeries. A single application of mitomycin C during surface corneal photoablative surgery seems a safe and efficient therapeutic option for eyes with corneal opacity and/or as prophylaxis in eyes with high risk for corneal opacity development. The use of this drug in photoablative surgery should be cautious until long-term safety results have been reported. The present text presents a review about corneal wound healing with the use of mitomycin C.