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Status unknownNCT02030990Updated Apr 15, 2022

The Use of MMC During PRK and Its Effect on Postoperative Topical Steroid Requirements

A Phase 2/3 interventional study of Mitomycin-C and Fluorometholone 1% topical ocular steroid in Corneal Opacity, sponsored by United States Naval Medical Center, San Diego. Status unknown at 1 site in United States. Open to participants aged 21 Years to 65 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2022-04-15.

Sponsored by United States Naval Medical Center, San Diego · Phase 2/3, Interventional, and Prevention

The sponsor has not verified this record recently (last verified Apr 2022), so the status shown — last known as Active, not recruiting — may be out of date.
Phase
Phase 2/3
Study type
Interventional
Enrollment
300
Allocation
Randomized
Ages
21 Years to 65 Years
Sex
All
01

Study summary

  1. Purpose To evaluate the use of mitomycin-C (MMC) as an intraoperative adjunct during photorefractive keratectomy (PRK), its effect on postoperative healing and its ability to reduce the postoperative topical steroid course after the surgery.
  2. Research Design This is a single-center, prospective, comparative cohort study.
  3. Hypothesis There will not be a significant difference in the refractive corrections amongst the treatment groups, 12 months after surgery.
  4. Objectives The primary study objective is to compare the effect of intraoperative MMC and a postoperative short topical steroid taper of 3 weeks, intraoperative MMC and a rapid topical steroid taper of 1 week, and a more commonly accepted postoperative regimen of a 2 month long topical steroid taper without any intraoperative MMC. The primary endpoint evaluated will be objective estimates of refractive error (WaveScan WaveFront™ System) at 12 months post-surgery. Secondarily, the extent of haze formation will be evaluated objectively using densitometry maps generated by automated Scheimpflug imaging of the cornea (Pentacam®). Furthermore, the subjective vision from the patients' perspective will be evaluated by questionnaires.
Read the detailed description
  1. Purpose To evaluate the use of mitomycin-C (MMC) as an intraoperative adjunct during photorefractive keratectomy (PRK), its effect on postoperative healing and its ability to reduce the postoperative topical steroid course after the surgery.
  2. Research Design This is a single-center, prospective, comparative cohort study.
  3. Hypothesis There will not be a significant difference in the refractive corrections amongst the treatment groups, 12 months after surgery.
  4. Objectives The primary study objective is to compare the effect of intraoperative MMC and a postoperative short topical steroid taper of 3 weeks, intraoperative MMC and a rapid topical steroid taper of 1 week, and a more commonly accepted postoperative regimen of a 2 month long topical steroid taper without any intraoperative MMC. The primary endpoint evaluated will be objective estimates of refractive error (WaveScan WaveFront™ System) at 12 months post-surgery. Secondarily, the extent of haze formation will be evaluated objectively using densitometry maps generated by automated Scheimpflug imaging of the cornea (Pentacam®). Furthermore, the subjective vision from the patients' perspective will be evaluated by questionnaire.
  5. Methodology At the Navy Refractive Surgery Center San Diego (NRSC SD), a total of 300 patients will be enrolled and randomly assigned to three cohorts. PRK will be performed in a standard fashion for all treatment groups. In the first two groups, intraoperative MMC 0.01% for a contact time of 15 seconds will be utilized. During the postoperative period, the first cohort will use the short steroid taper and the second cohort will use the rapid steroid taper. The third cohort will not receive any intraoperative MMC and will self-administer postoperative steroids, tapering for two months. All cohorts will be followed at 1 week, 1 month, 3 months, 6 months and 12 months after the procedure. Standard clinical measures of visual performance will be recorded. Since visually significant corneal haze is relatively rare, corneal densitometry will be used as an objective measure to detect subclinical corneal haze in addition to our usual subjective haze evaluation done by the clinical optometrists.

The patients will complete a voluntary questionnaire that evaluates their subjective impression of the refractive surgery, their recovery and their outcomes. Specifically, the patient will report the use of refractive correction, usefulness of the surgery at work, dry eye complaints, and subjective appraisal of their vision.

02

Conditions studied

  • Corneal Opacity

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Keywords

  • photorefractive keratectomy
  • corneal haze
  • mitomycin-C
  • postoperative steroids
03

In context

Corneal Opacity

37 studies on the registry are indexed under Corneal Opacity; 5 are open to participants now.

This study's planned enrollment of 300 is above the median of 27 across 20 interventional studies indexed under Corneal Opacity.

Browse Corneal Opacity studies →

Lead sponsor

United States Naval Medical Center, San Diego is the lead sponsor of 65 studies on the registry; 6 are open to participants now.

Of its 6 completed or terminated interventional studies of FDA-regulated products, 1 (17%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
21 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Active duty male or female, of any race, and at least 21 years old at the time of the pre-operative examination, and have signed an . The lower age limit of 21 is intended to ensure documentation of refractive stability.
  2. Manifest spherical equivalent (MSE) from +3.00 D to -11.0D with refractive cylinder of up to 3.00 D.
  3. Best spectacle corrected visual acuity of 20/25 or better in both eyes.
  4. Stable spectacle refraction, confirmed by clinical records. Neither the spherical nor the cylindrical portion of the refraction may have changed more than 0.50 D during the six-month period immediately preceding the baseline examination for myopic patients and 0.75 for hyperopic patients.
  5. Contact lens use: Soft contact lenses must have been removed at least two (2) weeks prior to baseline measurements. Hard contact lens users (PMMA or rigid gas permeable lenses) must have removed their lenses at least four (4) weeks prior to baseline measurements.
  6. Strong motivation for attending the follow-up visits and orders to remain in the area for the duration of at least twelve months of follow up.
  7. Consent of the subject's command to participate in the study.
  8. Access to transportation to meet follow up requirements.

Exclusion criteria

Exclusion Criteria:

  1. Aviators.
  2. Female subjects who are pregnant, breast-feeding, or intend to become pregnant during the course of the study.
  3. Concurrent topical or systemic medications which may impair healing, including , antimetabolites, isotretinoin, (Accutane™), amiodarone hydrochloride (Cordarone™), and/or sumatriptan (Imitrex™).
  4. Medical conditions which, in the judgment of the investigator, may impair healing, including but not limited to thyroid disorders and diabetes.
  5. Active ophthalmic disease, neovascularization of the cornea within 1 mm of the intended ablation zone, or lens opacity.
  6. Evidence of glaucoma or an intraocular pressure greater than 22 mm Hg at baseline.
  7. Evidence of keratoconus, corneal irregularity, or abnormal videokeratography in either eye.
  8. Patients with known sensitivity or inappropriate responsiveness to any of the medications used in the post-operative course.
  9. Any physical or mental impairment which would preclude participation in any of the examinations, such as inability to give verbal responses to eye charts.
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

05

Study design

Phase
Phase 2 / Phase 3
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Care provider)
Enrollment
300 participants (estimated)

Study arms

  • Experimental
    Mitomycin-C; 3 week FML steroid taper

    Mitomycin-C 0.01% will be administered intraoperatively during PRK for 15 seconds. The patient will take a 3 week fluorometholone 1% topical steroid taper.

    Drug: Mitomycin-C · Drug: Fluorometholone 1% topical ocular steroid

  • Experimental
    Mitomycin-C; 1 week FML steroid taper

    Mitomycin-C 0.01% will be administered intraoperatively during PRK for 15 seconds. The patient will take a 1 week of fluorometholone 1% topical steroid.

    Drug: Mitomycin-C · Drug: Fluorometholone 1% topical ocular steroid

  • Active comparator
    No mitomycin-C; 8 week FML steroid taper

    No mitomycin-C will be administered during the procedure. Instead a sham application of salt solution will be given for 15 seconds. The patient will take 8 weeks of topical fluorometholone 1% topical steroid drop taper.

    Drug: Fluorometholone 1% topical ocular steroid

Interventions

06

What researchers measure

Primary outcomes

  1. Refractive Error

    Objective refractive error with Wavescan Aberrometry

    Time frame: 12 months

Secondary outcomes

  1. Refractive Error

    Manifest refraction by patient subjective report

    Time frame: 12 months

  2. Corneal haze

    Subjective grading by slit lamp examiner

    Time frame: 12 months

  3. Corneal haze

    Subclinical objective measurement of corneal haze by Pentacam densitometry

    Time frame: 12 months

07

Study locations

1 site
  • Navy Warfighter Refractive Surgery Center
    San Diego, California 92134, United States
08

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 15, 2022, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT02030990
Lead sponsor
United States Naval Medical Center, San Diego
Responsible party
John Cason (MD., CDR US Navy, United States Naval Medical Center, San Diego) — Principal investigator
First posted
Jan 9, 2014
Start date
Aug 2014
Primary completion
Jan 2023 (estimated)
Completion
Jul 2023 (estimated)
Last update
Apr 15, 2022

Study contacts

John B Cason, M.D.
principal investigator · United States Naval Medical Center, San Diego
Donna Murdoch, Ph.D.
study director · Navy Warfighter Refractive Surgery San Diego

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is status unknown, as verified in Apr 2022. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Mitomycin

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