Low-dose mitomycin C as a prophylaxis for corneal haze in myopic surface ablation

Am J Ophthalmol. 2007 Nov;144(5):673-681. doi: 10.1016/j.ajo.2007.07.020. Epub 2007 Sep 24.


Purpose: To evaluate the efficacy of low-dose (0.002%) mitomycin C (MMC) vs no prophylactic MMC (control) in reducing corneal haze after surface laser ablation.

Design: Two-year retrospective follow-up study performed in Jaipur, India.

Methods: Ninety-two eyes with no MMC application and 83 eyes with 0.002% MMC application during laser epithelial keratomileusis (LASEK) were analyzed in a retrospective chart review with one month, two months, three months, six months, one year, and two years of postoperative follow-up. Postoperative haze, visual acuity, and efficacy ratio (EFFR) then were analyzed statistically.

Results: The no-dose MMC and low-dose MMC groups were statistically similar except for a thinner corneal pachymetry (P < .001), higher spherical equivalent error (P = .006), and smaller ablation zone (P = .009) in eyes not treated with MMC when subjected to univariate analysis. Multivariate analysis was used to overcome the preoperative statistical differences among the two groups. Eyes treated with low-dose MMC (0.002%) demonstrated statistically less haze at all postoperative time points and in each myopic subgroup (P < .001). The postoperative uncorrected visual acuity (UCVA) and EFFR, however, showed no difference between the groups, except for better EFFR with MMC at one month (P < .001) and two months (P = .034).

Conclusions: Low-dose MMC (0.002%) in eyes after LASEK results in less corneal haze than in eyes not receiving this agent. Concerns regarding the potential toxicity of MMC make a 10-fold less concentration more desirable in refractive surgery. Further comparative study of low- vs higher-dose MMC is recommended to characterize its clinical benefit fully.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cornea / drug effects
  • Corneal Opacity / prevention & control*
  • Female
  • Follow-Up Studies
  • Humans
  • Keratectomy, Subepithelial, Laser-Assisted*
  • Male
  • Middle Aged
  • Mitomycin / administration & dosage*
  • Myopia / surgery*
  • Nucleic Acid Synthesis Inhibitors / administration & dosage*
  • Postoperative Complications / prevention & control*
  • Premedication*
  • Retrospective Studies
  • Treatment Outcome
  • Visual Acuity


  • Nucleic Acid Synthesis Inhibitors
  • Mitomycin