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Yann Quentric, Philippe Daull, Emilie Gros, Sophie Antonelli, Virginie Mauro, Laurence Feraille, Jean-Sebastien Garrigue; Safety evaluation of cationic emulsions following refractive surgery procedures. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5297. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Refractive surgery is a very common method for correcting and improving vision. With the minimally invasive LASIK and SMILE procedures compared to PRK, refractive surgery is more and more popular among contact lenses and glasses wearer. Cationic emulsions (CEs) are novel eye drops designed for the management of signs and symptoms of dry eye; a condition that may appear as a post-refractive surgery complication. The aim of the present study was to evaluate the safety of local applications of cationic emulsions immediately after refractive surgery procedures.
PRK-like (manual superficial keratectomy, MSK) and LASIK-like were performed in rabbits (n=10 per surgical procedure and treatment group). The instillations of the cationic emulsions (Cationorm and a new cationic emulsion vehicle, CEv) or saline started immediately (1 h) after the surgery and lasted for 10 days (QID). Corneal fluorescein staining (CFS), cornea opacity, and in vivo confocal microscopy (IVCM) evaluations were performed during the course of the study. Corneal immunohistochemistry (anti-SMA and anti-ZO-1) and histopathology evaluations were performed at day 3, 7, and 10.
Re-epithelization of the cornea was almost complete at the end of the treatment period; 87.2±11.8%, 87.4±14.8%, 94.8±6.0% for Cationorm, CEv and saline, respectively. Cornea opacity score remains low for both CEs and were not different from saline at day 3, 7, and 10. SMA+ myofibroblast accumulation was higher following MSK (PRK-like) than LASIK-like. No difference was noted between the 3 groups for both surgical procedures. In eyes subjected to MSK, IVCM pictures of the anterior stroma at day 7 and 10 confirmed the presence of fibrosis that was identical in the 3 treatment groups. Following LASIK-like procedure, the eyes appeared normal (epithelium, anterior and posterior stroma, endothelium) in the 3 treatment groups at day 3, 7, and 10. ZO-1 immunohistochemistry of the wounded area did not reveal any increase in the percentage of abnormal cell junctions for the 3 treatment groups and 2 surgical procedures. Histopathology did not reveal any complications related to the use of the CEs immediately after the surgical procedures and confirmed their good tolerance.
This study demonstrates that the CEs (Cationorm and the new CEv) are well tolerated by the ocular surface that underwent MSK or LASIK-like refractive surgery procedures.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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