Epithelial heating rates with topical ciprofloxacin, ofloxacin, and ofloxacin with artificial tears after photorefractive keratectomy

Purpose: To determine whether corneal epithelial healing differs after the use of topical ciprofloxacin alone, topical ofloxacin alone, or topical ofl oxacin with artificial tears in patients having photorefractive keratectomy (PRK). Setting: Department of Ophthalmology and Visual Science, The University of Texas Health Science Center at Houston, Houston, Texas, USA. Methods: Eighteen patients (6 women, 12 men) with moderate myopia (-1.50 to -6.00 diopters [D]) had standardized PRK. Patient age ranged from 25 to 62 years. The 28 eyes (16 right, 12 left) were randomized into 3 treatment gr oups: ofloxacin alone, n = 9 eyes; ciprofloxacin, n = 9 eyes; and ofloxacin with Refresh Plus(R), n = 10 eyes. The drugs were administered immediately after surgery and then every 6 hours. Video recordings of the corneal woun ds stained with flourescein were performed at 8:00 AM and 4:00 P.M. using a video slitlamp camera with a cobalt-blue light until the wound completely healed. The videotaped images were recorded and analyzed by a computer plan imetry program. Wound areas were recorded and compared among the 3 drugs. T he square-root transformation was applied to the wound area to obtain a con stant healing rate. Statistical comparisons were analyzed using an analysis of variance test. Results: Mean recovery time was 82.67 hours +/- 14.42 (SD) in the ofloxacin eyes, 120.89 +/- 34.05 hours int the ciprofloxacin eyes, and 76.80 +/- 19. 30 hours in the ofloxacin with Refresh Plus eyes. Mean healing rate was 0.6 6 +/- 0.17 hours, 0.54 +/- 0.16 hours, and 0.67 +/- 0.15 hours, respectivel y. The healing rate was significantly higher in the ofloxacin with Refresh Plus eyes than in the ciprofloxacin eyes (P < .0001). There was no signific ant difference between the ofloxacin eyes and the ofloxacin with Refresh Pl us eyes (P = .42). Conclusion: Ofloxacin with Refresh Plus and ofloxacin alone had a more posi tive effect on epithelial healing than ciprofloxacin. The ciprofloxacin eye s were significantly more prone to impaired or delayed wound healing and to the development of corneal haze. J Cataract Refract Surg 2000; 26:690-694 (C) 200 ASCRS and ESCRS.