Epithelial Wound Healing after Cataract Surgery Comparing Two Different Topical Fluoroquinolones

PURPOSE: To compare the epithelial wound healing response of two preservative-free fluoroquinolones, moxifloxacin and levofloxacin, in patients who underwent cataract surgery. MATERIALS AND METHODS: In this prospective, evaluator-masked, randomized clinical trial, 59 eyes of 50 patients who underwent cataract surgery were enrolled. Patients were randomized to receive moxifloxacin 0.5% (n=32 eyes) or levofloxacin 0.5% (n=27 eyes). All patients instilled moxifloxacin or levofloxain four times daily for 1 week prior to surgery and 2 weeks after surgery. The epithelial wound healing status in the corneal incision site was scanned with a raster scan mode of fourier-domain optical coherence tomography (FD-OCT). The number of eyes showing epithelial defect images and average number of corneal epithelial defect cuts per eye were compared between groups. All patients were evaluated on postoperative days 1, 2, 3, and 10. RESULTS: On postoperative days 1, 2, and 3, the number of eyes showing epithelial defects in FD-OCT was not statistically different (all p>0.05). The average number of corneal epithelial defect cuts was also not statistically different between the two groups (all p>0.05). No eyes showed epithelial defects on postoperative day 10 in either group. CONCLUSION: There were no differences on epithelial wound healing comparing these two different fluoroquinolones at the incision site of cataract surgery.

Effects of Interleukin-6 on Corneal Epithelial Wound Closure after Excimer Laser Surface Ablation in Rabbits

To evaluate the effects of interleukin-6(IL-6) on epithelial migration in corneal epithelial wound healing process after excimer laser surface ablation, the morphologic changes as well as the healing rate of the defect area were observed on 30 rabbits(60 eyes). The animals were divided into three groups of twenty each: the control group and the two IL-6 treated groups(eye dropping with 0.1mg/L and 1.0mg/L of IL-6). On light microscopic examination, after 9 hours, centripetal migration of epithelial cells and covering of bare stroma with monolayered epithelial cells were more remarkable in the 1.0mg/L group than in the control group, reaching the peak at 18 hours. On transmission electron microscopic examination after 18 hour, the 1.0mg/L group showed the loss of hemidesmosome beneath the leading edge of sliding epithelial cell, other intracellular structures were well preserved. On scanning electron microscopic examination, epithelial migration started at 9 hour in all three groups and the epithelial migration was more rapid in the 1.0mg/L group than in the control group. Fifteen hours and afterwards, the healing rate was significantly accelerated in the 1.0mg/L group than in the control group. In view of the above findings, it was speculated that IL-6 could be used effectively in the early treatment of excimer laser keratectomy and other corneal epithelial injury.

Delayed Corneal Epithelial Wound Healing after Excimer laser Photorefractive Keratectomy

The purpose of this study was to evaluate the occurrence of delayed epithelial healing(DEH) and the factors associated with it after excimer laser photorefractive keratectomy(PRK) and to assess whether there are any difference in the clinical outcomes between the eyes of DEH group and normal epithelial healing(NEH) group. This retrospective study was done in 554 consecutive eyes which had eximer laser PRK(VISX 20/20B WisionKey system with central island removal program) by one surgeon(S.B.L) between September 1994 and April 1997 at Yeungnam University Medical Center. Mean reepithelializion time of all 554 eyes was 3.1+/-1.3 days. Delayed epithelial healing beyond postoperative 5 and 7 days after exicimer laser PRK were noted in 30 eyes(5.4%) and 8 eyes(1.4%) of all 554 eyes, respectively. Mean reepithelialization time of DEH group was 7.1 days(range 5~12 days). Occurrence of DEH after excimer laser PRK was not depending on sex, age, laterality, amount of attempted correction(-6D or -6D), type of procedure(PRK vs. PARK), use of Maclof, the order of operation(type eye vs. second eye) or the type of soft ware(version 3.20 vs. 4.01)(All: p>0.05). At 6 months after surgery, 16 eyes(64%) of total 25 eyes of DEH group achieved UCVA of 0.7 or better, and 14 eyes(56%) were within +/-1D of emmetropia. In the NEH group. 349 eyes(84.7%) were UCVA of 0.7 or better, and 365 eyes(88.4%) were within +/-1D of emmetropa. There was statistically significant decrease in the clinical outcome of DEH group being compared with NEH group(p<0.05) In conclusion, prompt management for complete epithelial wound healing should be done in the cases of delayed epithelial healing after excimer laser PRK because it can cause the decrease in clinical outcome. Further studies assessing the effects of numerous topical medications, preservatives and software on epithelial healing after exicimer laser PRK would be performed.

The Effect of Epidermal Growth Factor on Cornea Epithelial Wound Healing in Excimer Laser Keratectomized Rabbits

Epidermal growth factor(EGF), which exists as a constant component of human fluid, was known to stimulate the proliferation and migration of corneal epithelial cells. We investigated the effect of EGF on cornea epithelial wound healing after excimer laser keratectomy. The corneal wound healing was evaluated at every 6 hours on 30 rabbit eyes (5 group) exposed to different EGF concentrations during the organ culture. The results obtained are as follows: The area of epithelial defect was significantly smaller in the EGF treated groups as compared with the control group. However, there was no statistical difference in the area of epithelial defect among the different concentrations of the EGF treated group. The rates of the wound healing in the EGF treated groups seem to be faster than the control group, however, it was statistically insignificant. At 6 and 12 hours after the culture, the rates of wound healing of all the EGF treated group were significantly faster than thouse of the control group. Therefore, the exogenous EGF was found to be effective on the experimental cornea epithelial wound healing after excimer laser keratectomy, showing its maximal effect at 12 hours after treatment.