Topical vitamin E and hydrocortisone acetate treatment after photorefractive keratectomy

Purpose To investigate the effects of topical vitamin E and hydrocortisone acetate treatments on corneal healing response after -10.0 D photorefractiv e keratectomy (PRK) in rabbits. Methods Thirty-three New Zealand white rabbits were divided into four group s and -10 D PRK was performed under in vivo conditions. Following PRK, grou p 1 (n = 9) received no topical treatment and served as control. Group 2 (n = 8) received 0.1% hydrocortisone acetate ointment twice a day, group 3 (n = 8) received 1% vitamin E ointment and group 4 (n = 8) received both 0.1% hydrocortisone acetate and 1% vitamin E twice a day for a month. At the en d of the third month, corneal haze was graded and the conceal hydroxyprolin e levels were measured, as a crude indicator of new collagen synthesis. Fin ally corneal samples were examined by transmission electron microscopy. Results Non-homogeneously distributed strong haze was identified in group 1 which was greater than in the other groups; haze was least in groups 2 and 4. Corneal hydroxyproline levels were found to be significantly lower in g roups 2,3 and 4 compared with the control (Student's t-test, p < 0.05). His topathologically, the most aggressive wound healing response was detected i n group 1. The corneal wound healing response of group 2 was less than that of group 1 and equal to or more than that of group 4. Conclusions Deep corneal photoablation induces an aggressive healing respon se, and topical hydrocortisone acetate reduces this corneal wound healing e ffectively. The inhibitory effect of topical vitamin E on corneal wound hea ling seems to be less than that of hydrocortisone acetate, but combined tre atment with these two drugs may have an additive effect in controlling corn eal wound healing after PRK.