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C.G. Blehm, R.W. Yee; Effects of Fourth–Generation Fluoroquinolones in Epi–LASIK Flap Wound Healing . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4877.
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Purpose: To determine if there are clinical differences between VigamoxTM and ZymarTM therapeutic regimens on corneal epithelial flap healing for patients undergoing Epi–LASIK. Methods: This was a prospective, randomized by eye, double–masked, single–center clinical trial in which eleven patients scheduled to undergo epi–excimer laser in situ keratomileusis (Epi–LASIK) for the correction of myopia with or without astigmatism were enrolled. With ketorolac, patients received QID VigamoxTM or ZymarTM 3 days prior to surgery, were dilated at surgery with phenylephrine, cyclopentolate, and tropicamide. Intraoperatively, proparacaine, ketorolac and antibiotic were administered. Antibiotic plus EconoPred PlusTM 1% four times daily were administered for one week postoperative. EconoPred PlusTM 1% was continued twice daily on days 8–14. The outcome measures were flap clarity, stromal edema, flap edema, epithelial defect (scale 0–4; 0 = mild; 4 = severe) and uncorrected distance visual acuity. Masked grading of the ophthalmic parameters was conducted on post–op days 1, 4 and 7. Results: No significant differences were observed for any of the parameters in terms of flap clarity, stromal edema, flap edema, epithelial defect. Scores (mean ± std. dev.) for moxifloxacin and gatifloxacin were 1 (± 0.8) and 1.3 (± 1.1) for flap clarity, 0.4 (± 0.5) and 0.6 (± 0.8) for stromal edema, 0.9 (± 0.4) and 1.0 (± 1.0) for flap edema, respectively, at day 1 post surgery. There was no significant difference between groups in visual acuity one week after surgery (P > 0.05). Conclusions: These results suggest that there were no differences in flap clarity, stromal edema, flap edema, epithelial defect or visual acuity between the two fourth–generation fluoroquinolones, moxifloxacin 0.5 % ophthalmic solution and gatifloxacin 0.3% solution, used in patients undergoing Epi–LASIK.
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