TUESDAY 12TH SEPTEMBER
MAGEK (mitomycin-C augmented guarded external keratectomy) versus PRK: 5 year follow-up
PURPOSE: To compare the haze rate, safety and predictability of mitomycin augmented guarded external keratectomy (MAGEK) versus conventional PRK in a retrospective comparative study. SETTING: Regional T.I. Eroshevsky Ophthalmic Hospital, Samara, Russian Federation. METHODS: The long-term data of the first 400 consecutive MAGEK procedures performed since October, 2000 were compared with those of 400 consecutive PRK cases from 1998-2000 files of the same clinic. Both groups were similar in age, gender, and refraction with mean SE -6,15±0,23D in PRK-treated group (up to -14,65D attempted correction) and mean SE -6,24±0,21D in MAGEK group (correction up to -14,00D). Photoablation procedure was identical in both groups. 0,02% MMC solution was applied in MAGEK cases for 2 minutes followed by BSS irrigation. High Dk/t silicon-hydrogel contact lenses covered the corneas until re-epithelialization. RESULTS: MMC did not affect re-epithelialization. Trace haze (up to 0,5 degree) appeared temporary (mostly during the first 2-3 months postop) in only 3,0% of MAGEK cases, while PRK-treated eyes showed 23,5% of haze (mainly 1-2 degree). Complications were minor and same (1 mild keratitis and 1 contact lens lost) in each group. Mean haze rate in MAGEK group was 7 times less than in PRK group (p"0,00001). Safety of MAGEK procedure was higher (p"0,05). Postoperative refraction was within ±0,5D in 96,7% of MAGEK eyes vs. 80% of PRK eyes. CONCLUSIONS: In 5 years follow-up MAGEK appears to be highly safe and predictable refractive procedure even for high and extreme myopia. The complication rate of prophylactic refractive corneal MMC application remains remarkably low.
E. Spiridonov, A. Zolotaryov, Z. Kluyeva, RUSSIA