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Refractive regression after pediatric excimer laser surgery with and without use of mitomycin

Poster Details

First Author: M.Diab SAUDI ARABIA

Co Author(s):                  

Abstract Details



Purpose:

Substantial regression (return of ametropia) is a drawback to excimer laser correction of high refractive errors in children. The anti-metabolite mitomycin C (MMC) is used in adult LASIK/PRK to minimize regression or corneal haze when treating higher refractive errors. Here we report outcomes in children treated with the excimer laser with and without intra-operative use of MMC

Setting:

Faculty of Medicine AIN Shams Univeristy Cairo Egypt and also Magrabi Hospital KSA

Methods:

Clinical course and outcome data were collated prospectively in a group of 233 ametropic children and adolescents (366 treated eyes; mean age 9.8 yrs, range 2-19 yrs) who had difficulties with spectacle/contacts lens wear. Myopia (285 eyes) ranged - 3.00 to -11.5 D (mean -8.2 D) and hyperopia (81 eyes) +3.5 to +6.25 D. Excimer laser ablation was used to treat isoametropia in 266 eyes and anisometropia in 100 eyes under brief general anesthesia with or without application of MMC. Mean follow-up was 4.4 yrs (range 5 mos - 10 yrs).

Results:

Myopia correction averaged 7.5 D and hyperopia correction 4.3 D. 87% of eyes were corrected initially to within ±1 D of goal refraction. MMC was applied in a subgroup of 31 children (48 eyes). Over similar follow-up intervals, regression with use of MMC was reduced 56% in myopic and 52% in hyperopic eyes (chi square, p = .04 and .03). No substantial differences were observed in grade of corneal haze. MMC treated eyes required a mean 1.2 days longer to heal

Conclusions:

Application of MMC in children after excimer laser ablation reduces but does not eliminate refractive regression (return of ametropia). Further study is indicated to determine the long-term safety of MMC use in pediatric refractive surgery

Financial Disclosure:

NONE

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