Our Experience With Mitomycin Intravascular Chemoembolization (Mice) In Various Corneal Pathologies And Preparing The Cornea For Future Transplant Surgery
Published 2025 - 43rd Congress of the ESCRS
Reference: PO602 | Type: Free paper | DOI: 10.82333/aev3-r417
Authors: Maria Laura Passaro* 1 , Deniz Kilic 2 , Gianni Virgili 3 , Vito Romano 4 , Ersilia Lucenteforte 5 , H. Burkhard Dick 6 , Suphi Taneri 6
1Department of Neurosciences, Reproductive Sciences and Dentistry,University of Naples “Federico II”,Naples,Italy, 2Dunyagoz Hospital, ,Izmir,Türkiye, 3University of Firenze,Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA),Firenze,Italy, 4University of Brescia,Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health,Brescia,Italy, 5University of Firenze,Department of Statistics, Computer Science and Applications "G. Parenti",Firenze,Italy, 6Ruhr-University Bochum,In der Schornau,Bochum,Germany
Purpose
Corneal neovascularization poses a significant challenge in ocular surface disease, especially when related to corneal transplant surgery. Mitomycin intravascular chemoembolization (MICE) is a relatively new technique, introduced in ophthalmology in 2020 by Dean Ouano, that selectively targets abnormal vessels to block them and prevent further lipid deposition subsequently improving corneal clarity. This study evaluates the effectiveness of MICE in patients with corneal neovascularization including patients who required corneal transplantation for visual rehabilitation.
Setting
This study was conducted at the S. Malayan Eye Center, Yerevan, Armenia, from 2022 to 2025. Twelve patients (twelve eyes) with corneal neovascularization were selected to undergo the MICE procedure.
Methods
The cohort included eight patients with lipid keratopathy due to herpetic keratitis (quiescent for 3 years), one with a history of pneumococcal ulcer (four years prior) and 2 with failed corneal transplant, and one with history of chemical injury.
Three months post-MICE, four patients proceeded with penetrating keratoplasty (PK) for visual improvement. One patient underwent an unconventional autotransplantation from a non-seeing but clear cornea to the contralateral eye, which had visual potential despite corneal scarring. Another patient with a vascularized corneal graft sought MICE purely for cosmetic improvement.
Results
Chemoembolization was successfully achieved in all cases, leading to vessel sclerosis and stabilization. The mean follow-up period for corneal transplant patients was 13.1 months, during which transplanted corneas remained clear, and no recurrence of neovascularization was observed in the treated vessels.
Three patients experienced significant visual improvement, with best-corrected visual acuities (BCVA) ranging between 20/100 and 20/30.
The autotransplantation patient improved to 20/500, though further recovery was limited by pre-existing optic nerve atrophy.
The patient who underwent MICE for cosmetic purposes achieved the desired aesthetic improvement.
Conclusions
MICE represents a promising procedure for managing corneal neovascularization and it’s beneficial especially in patients necessitating corneal transplantation Also may also improve the cosmetic appearance.. By selectively ablating pathological vessels, this technique reduces vascular burden, enhances graft survival, and, in some cases, facilitates visual improvement. Our findings suggest that patients with quiescent neovascularization for at least three years may benefit most when MICE is performed at least three months before corneal transplantation. As this approach gains wider adoption, further research is needed to refine patient selection criteria and optimize treatment protocols.