Mitomycin-C in corneal surface excimer laser ablation techniques: a report by the American Academy of Ophthalmology.

Details

Serval ID
serval:BIB_53ECC19F6631
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Mitomycin-C in corneal surface excimer laser ablation techniques: a report by the American Academy of Ophthalmology.
Journal
Ophthalmology
Author(s)
Majmudar P.A., Schallhorn S.C., Cason J.B., Donaldson K.E., Kymionis G.D., Shtein R.M., Verity S.M., Farjo A.A.
ISSN
1549-4713 (Electronic)
ISSN-L
0161-6420
Publication state
Published
Issued date
06/2015
Peer-reviewed
Oui
Volume
122
Number
6
Pages
1085-1095
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Abstract
To review the published literature assessing the efficacy and safety of mitomycin-C (MMC) as an adjunctive treatment in corneal surface excimer laser ablation procedures.
Literature searches of the PubMed and Cochrane Library databases were last conducted on August 19, 2014, without language or date limitations. The searches retrieved a total of 239 references. Of these, members of the Ophthalmic Technology Assessment Committee Refractive Management/Intervention Panel selected 26 articles that were considered to be of high or medium clinical relevance, and the panel methodologist rated each article according to the strength of evidence. Ten studies were rated as level I evidence, 5 studies were rated as level II evidence, and the remaining 11 studies were rated as level III evidence.
The majority of the articles surveyed in this report support the role of MMC as an adjunctive treatment in surface ablation procedures. When MMC is applied in the appropriate concentration and confined to the central cornea, the incidence of post-surface ablation haze is decreased. Although a minority of studies that evaluated endothelial cell density (ECD) reported an MMC-related decrease in ECD, no clinical adverse outcomes were reported.
Over the past 15 years, the use of MMC during surgery in surface ablation has become widespread. There is good evidence of the effectiveness of MMC when used intraoperatively as prophylaxis against haze in higher myopic ablations. Although there are reports of decreased endothelial counts after the administration of MMC during surgery, the clinical significance of this finding remains uncertain, because no adverse outcomes were reported with as much as 5 years of follow-up. Optimal dosage, effectiveness as prophylaxis in lower myopic and hyperopic ablations, and long-term safety, particularly in eyes with reduced corneal endothelial cell counts from prior intraocular surgery, have yet to be established.
Keywords
Academies and Institutes, Alkylating Agents/administration & dosage, Alkylating Agents/adverse effects, Combined Modality Therapy, Cornea/physiopathology, Corneal Surgery, Laser/methods, Humans, Lasers, Excimer/therapeutic use, Mitomycin/administration & dosage, Mitomycin/adverse effects, Myopia/drug therapy, Myopia/physiopathology, Myopia/surgery, Ophthalmology, Postoperative Complications/prevention & control, Technology Assessment, Biomedical, United States, Vision Disorders/physiopathology, Vision Disorders/prevention & control, Visual Acuity/physiology
Pubmed
Web of science
Create date
30/09/2019 16:05
Last modification date
06/10/2019 5:26
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