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J.M. Burka, K.S. Bower, R.C. VanRoekel, R.D. Stutzman, C. Kuzmowych, R.S. Howard; Comparison of the Effect of 4th Generation Fluoroquinolones, Gatifloxacin and Moxifloxacin, on Epithelial Healing Following Photorefractive Keratectomy (PRK) . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4879.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To compare the rate of epithelial healing following photorefractive keratectomy (PRK) after the use of two commercially available 4th generation fluoroquinolones, moxifloxacin (Vigamox®, Alcon Laboratories, Fort Worth, Texas) and gatifloxacin (Zymar ®, Allergan, Inc, Irvine, California). Methods: 35 subjects were included in this double–blinded, randomized, prospective trial. Patients were randomly assigned to one of two groups. Group A received Vigamox in the right eye and Zymar in the left. Group B received Zymar in the right eye and Vigamox in the left. PRK was performed on all subjects after creating a 9.0mm epithelial defect using 20% alcohol for 25 seconds after which a therapeutic bandage contact lens was applied to the ablated surface for all patients. Patients were examined daily after surgery until the epithelium had healed completely in both eyes. Beginning on post–op day 3, photos were taken and used to confirm epithelial healing or measure the area of residual epithelial defects. Healing times and defect sizes were compared using the Wilcoxon signed ranks test. Results: While median healing time for both groups was 4 days (Vigamox range: 3 to 7 days, Zymar range: 3 to 9 days), only 69% of Zymar–treated eyes had healed by day 4 compared to 80% of the Vigamox–treated eyes (P=0.01). Successful removal of the bandage contact lens was accomplished earlier (P=0.042) in the Vigamox group (median: 3, range: 3 to 7) than the Zymar group (median: 4, range 3 to 9). Both eyes healed on the same day in 18 of the 35 subjects (51.4%). In 13/35 (37.1%) subjects the Vigamox–treated eye healed first, compared to only 4/35 (11.4%) whose Zymar–treated eye healed first. Moreover, all 6 of the eyes that took 2 days longer than their fellow eye to heal were Zymar–treated eyes. Overall, on each postoperative day, defect sizes were greater for the Zymar–treated eyes. This difference was statistically significant on day 4 (P=0.027) and a similar trend was seen on day 5 (P=0.055). One Zymar treated eye developed peripheral corneal infiltrates on postop day #4 that resolved after removal of the bandage contact lens. There were no significant adverse effects reported in the Vigamox–treated eyes. Conclusions: Eyes treated with Vigamox healed faster and had smaller defects compared to those treated with Zymar. This provides another factor to consider in selecting antibiotic prophylaxis for corneal refractive surgery.
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