Targeted Mitomycin C Intravascular Chemoembolization (Mice) For Corneal Neovascularisation: Pilot Clinical Outcomes

Corneal neovascularisation is a vision-threatening condition characterised by abnormal vessel ingrowth, leading to stromal scarring, lipid deposition, and increased risk of graft rejection. Current vessel-directed treatments - including fine-needle diathermy, anti-vascular endothelial growth factor agents, and laser photocoagulation - demonstrate variable and often limited efficacy. Mitomycin C (MMC) intravascular chemoembolization (MICE) involves direct intravascular MMC injection to induce endothelial obliteration and vessel regression. This pilot study evaluates the safety and clinical efficacy of MICE for corneal neovascularisation.

Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, United Kingdom.

A retrospective review was performed of all patients undergoing MICE for corneal neovascularisation between April 2025 and January 2026. Data were extracted from electronic patient records. MMC (0.2 or 0.4 mg/mL) was delivered via 34-gauge needle cannulation of corneal vessels with controlled retrograde injection. Patients were reviewed at 1 week, 1 month, 3 months, and 6 months. Outcomes included visual acuity (VA), clock-hours of neovascularisation, and photographic assessment of vessel regression.

Seven eyes of seven patients (median age 54.5 years, range 44–71) with mixed-aetiology corneal neovascularisation underwent MICE; one eye required repeat treatment. Median baseline neovascularisation was 3 clock hours (range 1–4). At 1 month, regression was observed in all eyes (100%), with median involvement reduced to 1 clock hour (range 0–2). VA improved in 2 eyes, remained stable in 4 eyes, and reduced in 1 eye due to unrelated retinal detachment. No intraoperative or postoperative complications or adverse events were observed.

MICE demonstrated favourable safety and consistent early regression of corneal neovascularisation in this pilot cohort. Direct intravascular MMC delivery may provide a targeted alternative for established corneal vessels when conventional therapies are insufficient. Larger prospective studies are required to evaluate durability and long-term outcomes.