Effect of topical fluoroquinolones on corneal re-epithelialization after excimer laser keratectomy

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Abstract
Purpose: To measure the effects of commercially prepared topical fluoroquinolones on the healing rate of epithelial defects in the rabbit cornea after excimer laser keratectomy. Setting: The Doheny Eye Institute and the Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles, California, USA. Methods: Twenty-four New Zealand white rabbits had unilateral excimer laser superficial keratectomy to create a circular, central corneal epithelial defect. Following keratectomy, each rabbit was randomly assigned to one of three treatment groups, each consisting of eight rabbits. Each rabbit was treated with one drop of the assigned medication, each hour until epithelialization was complete; Group 1 received ciprofloxacin, Group 2, ofloxacin, and Group 3, preservative-free artificial tears as a control. The epithelial defect was stained with fluorescein and photographed every 12 hours with a cobalt blue filtered light. Planimetric measurements of the wound area were made with an image analysis system. Results: The control group eyes were re-epithelialized within 84 hours. The fluoroquinolone-treated eyes required 144 hours for complete healing. Both ciprofloxacin and ofloxacin significantly delayed corneal epithelial healing (P = .0055) compared with the control. Two animals treated with topical ciprofloxacin developed a white precipitate in the area of the epithelial defect; however, the precipitate did not prevent closure of the epithelial defect. No such precipitate was seen with ofloxacin. Conclusion: These data suggest that both ofloxacin and ciprofloxacin influence corneal wound healing in rabbits after laser keratectomy and that their healing rates did not differ. A white precipitate that appeared in the epithelial defect area in some rabbits treated with ciprofloxacin did not prevent closure of the defect.