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C. Nien Shy, K. J. Flynn, M. Chang, D. J. Brown, J. V. Jester; Predforte® but Not Restasis® Reduces Peak Corneal Haze After Photorefractive Keratectomy (PRK) in Rabbits. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2860.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the effects of topical cyclosporine (Restasis®) compared to steroids (PredForte®) on corneal haze, thickness and stromal cell density after PRK.
Fifteen eyes(15 rabbits) received 9-D PRK. After the surgery, rabbits were divided into 3 groups and treated for 4 weeks with either PredForte®, Restasis® or used as control. PredForte® was administered 4 times a day during the first week and tapered over the next 3 weeks. Restasis® was administered twice a day for 4 weeks. Corneal haze was measured by in vivo confocal microscopy prior to and 2, 4, 6, 8, and 12 weeks postsurgery. At week 12, animals were sacrificed and corneas were evaluated for collagen organization by ex-vivo 2-photon second harmonic generation (SHG) and stromal cell density using DAPI staining of nuclei.
Corneal haze was significantly reduced in the PredForte® treated group compared to the Restasis® and control groups during the first 4 weeks after surgery (p< 0.002). At 6 weeks, haze slightly increased in the PredForte® group. For control and Restasis® groups, haze increased progressively reaching values peaked at 4 weeks after PRK and then slowly declined but remained elevated at 12 weeks. Stromal thickness was not statistically different at any time between groups (p=ns). Epithelial thickness was significantly reduced at day 7 after surgery in the PredForte® treated group (13.0µm compared to 35.4µm and 30.0µm for PredForte®, control and Restasis® respectively,p< 0.02) but no significant difference was detected 12 weeks after PRK between groups. Scar thickness measured at 12 weeks by SHG was not significantly different between the 3 groups (57.64µm, 55.58µm and 54.21µm for control, Restasis® and PredForte® respectively,p=ns). Stromal cell density count at 12 weeks had a tendency to be lower in the Pred Forte® treated group (43,723 vs 63,077 and 67,080 for Pred Forte®, control and Restasis® respectively,p=ns).
Restasis® has no effect on wound healing following PRK while PredForte® significantly reduces peak corneal haze but has no effect on long-term corneal fibrosis after discontinuation of the drug.
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