EFFECT OF DICLOFENAC, KETOROLAC, AND FLUOROMETHOLONE ON ARACHIDONIC-ACID METABOLITES FOLLOWING EXCIMER-LASER CORNEAL SURGERY

Objective: To compare the ability of several topical anti-inflammatory agents to modulate the production of prostaglandin E(2) after excimer laser ablation in rabbit cornea. Methods: Adult New Zealand white rab bits were subjected to phototherapeutic keratectomy with a commerciall y available excimer laser. Prostaglandin E(2) and leukotriene Bq were detected by enzyme-linked immunoassay, and leukocyte infiltration was determined histologically. Results: Prostaglandin E(2) and leukocyte i nfiltration increased in the cornea after excimer ablation. Treatment with topical fluorometholone and diclofenac sodium significantly reduc ed prostaglandin E(2) levels. Corneas treated with diclofenac had sign ificantly higher levels of leukocyte infiltration than those treated w ith ketorolac tromethamine. No changes in leukotriene B-4 levels were detected in this model. Conclusions: As a group, topical anti-inflamma tory medications tend to lower prostaglandin E(2) levels in rabbit cor neas subjected to excimer ablation, but differ in their ability to red uce polymorphonuclear leukocyte infiltration. Further work is needed i n this model to understand how these drugs alter leukocyte infiltratio n of the remaining stromal bed.