Topical Diclofenac Treatment Prior to Excimer Laser Photorefractive Keratectomy in Rabbits

PURPOSE: This study sought to determine whether pre- and posttreatment with topical diclofenac sodium 0.1% eye drops suppresses corneal inflammation after 193-nanometer excimer laser corneal ablation more effectively than does posttreatment alone. METHODS: Eight rabbits were divided into four groups. Animals in group I were treated with topical diclofenac every half hour for 2 hours prior to photorefractive keratectomy; treatment was continued every hour for 3 hours after the ablation. Group Il animals, used as controls, were treated with the diclofenac vehicle according to the same schedule. The third group (III) received diclofenac topically only after the excimer laser ablation. The fourth group (IV) consisted of normal corneas from these same animals. At 3 hours after ablation, prostaglandin E? (PGE2) levels were measured in the corneas ana leukocytes were quantified. RESULTS: Treatment with topical diclofenac significantly reduced levels of PGE2 compared to treatment with the vehicle (p = .024). Presurgical treatment with topical diclofenac did not result in greater suppression of PGE2 than did posttreatment alone (5.72 ± 0.91 pg/m L versus 5.79 ± 1.29 pg/mL). Similarly, there was a significant inhibition of leukocyte invasion in the diclofenac treated corneas (I vs II: ? = .019, ill vs II: ? = .024), but no statistically significant difference between pretreatment and posttreatment alone groups (I vs III: P = .72). CONCLUSIONS: Topical administration of diclofenac reduces the release of PGE2 and the migration of polymorphonuclear leukocytes in the rabbit cornea 3 hours after 193-nanometer excimer laser ablation. However, pretreatmenf of the cornea, starting 2 hours prior to laser surgery, does not seem to offer advantages over postablation treatment in this animal model. Refract Corneal Surg. 1993;9:437-442.) RÉSUMÉ INTRODUCTION: Nous voulions étudier comparativement l'inflammation cornéenne dans les yeux traités avec diclofenac sodium avant et après kératectomie photorefractive au laser excimer 193 nm avec yeux traités uniquement en postopératoire. MÉTHODES: Huit lapins furent divisés en 4 groupes. Les animaux du groupe I furent traités avec les gouttes de diclofenac toutes les 30 minutes pendant deux heures avant la kératectomie photorefractive et toutes les heures pendant trois heures post-opérativement. Le deuxième groupe servait de cas témoin, traité seulement avec le véhicule. Le troisième groupe recevait diclofenac uniquement en post-opératoire. Le quatrième groupe était constitué des cornées normales de ces animaux mêmes. Trois heures après la chirurgie, les niveaux de prostaglandin E2 (PGE2) furent mesurés et le nombre de leucocytes compté.