Postoperative umbilical cord serum eye drops versus intraoperative mitomycin-C in photorefractive keratectomy for moderate myopia

Purpose To evaluate the efficacy and safety of umbilical cord serum (UCS) eye drops compared with intraoperative mitomycin-C (MMC) in enhancing corneal epithelial healing, reducing stromal haze, and improving early postoperative outcomes following photorefractive keratectomy (PRK). Patients and methods This prospective, randomized, case-control study included PRK patients with (−1.5 to −6 D) myopia and (≤−4 D) astigmatism. Participants were randomized into two groups: the study group received postoperative UCS eye drops (20% diluted with artificial tears), while control group received intraoperative MMC (0.02%) for up to 40 s. Both groups followed standard postoperative therapy. Outcomes measured included epithelial healing time, corneal haze (densitometry), uncorrected distance visual acuity, postoperative pain, and tear film stability. Results The study included 79 eyes from 40 patients. The mean age was 25.05±7.81 years in the UCS group and 29.14±5.48 years in the MMC group ( P =0.061). The mean spherical equivalent (SE) was −2.53±1.38 D in the UCS group and −2.55±1.49 D in the MMC group ( P =0.95). Epithelial healing was significantly faster in the UCS group (3.51±0.51 days vs. 4.67±1.3 days, P <0.001). Postoperative haze was lower in the UCS group ( P <0.05). Uncorrected distance visual acuity was significantly better at 1 and 2 weeks postoperatively ( P <0.001), though long-term outcomes were similar. Pain scores were lower in the UCS group on postoperative day 2 ( P =0.012). Tear film stability remained unchanged, and no adverse events were observed. Conclusion UCS eye drops enhance epithelial healing, reduce corneal haze, and improve early visual recovery, with a comparable safety profile to MMC. UCS may serve as a promising biologic alternative to MMC in PRK postoperative management. Further large-scale studies are needed to validate these findings.