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Comparison of the effects of fourth-generation fluoroquinolones on corneal re-epithelialization in rabbit eyes

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Abstract

Background

Gatifloxacin and moxifloxacin ophthalmic solutions are frequently prescribed for antimicrobial prophylaxis following cataract and corneal refractive surgeries, although the use of topical antibiotics is likely to interfere with wound healing in the immediate postoperative period. A potential factor that may influence rates of wound healing or corneal re-epithelialization is how the solutions are preserved. Gatifloxacin is preserved with 0.005% benzalkonium chloride, whereas moxifloxacin is unpreserved. The purpose of this study was to evaluate the effects of commercially prepared topical gatifloxacin and moxifloxacin on corneal re-epithelialization in rabbit eyes.

Methods

In this randomized, prospective, controlled study, 17 New Zealand white rabbits underwent bilateral corneal de-epithelialization procedures using 20% alcohol contained within a 6 mm trephine. Postoperatively, eyes were randomly assigned to receive either gatifloxacin 0.3%, moxifloxacin 0.5%, or balanced salt solution (BSS) four times daily. Each 6 hours during the first 2 days, and every 12 hours thereafter slit-lamp measurements and corneal photography were performed, enabling de-epithelialized surface areas to be calculated via EPCO 2000 computer analysis.

Results

Gatifloxacin (n = 12) and moxifloxacin (n = 13) treated eyes had a statistically significant (p = 0.036) delay in epithelial healing relative to controls (BSS, n = 8). Healing rates of gatifloxacin and moxifloxacin treated eyes were not significantly different (p = 0.545).

Conclusions

We found no significant difference in re-epithelialization rates following topical application of gatifloxacin 0.3% and moxifloxacin 0.5%. Both antibiotic solutions delayed healing compared to BSS. Our analysis suggests that there was no apparent added epithelial toxicity due to the presence of BAK in the gatifloxacin preparation.

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References

  1. Mah FS (2004) Fourth generation fluoroquinolones: new topical agents in the war on ocular bacterial infections. Curr Opin Ophthalmol 15:316–320 doi:10.1097/00055735–200408000–00007

    Article  PubMed  Google Scholar 

  2. Goldstein MH, Kowalski MS, Gordon J (1999) Emerging fluoroquinolone resistance in bacterial keratitis. Ophthalmology 106:1313–1318

    PubMed  CAS  Google Scholar 

  3. Noecker R (2001) Effects of common ophthalmic preservatives on ocular health. Adv Ther 18:205–215 doi:10.1007/BF02853166

    Article  PubMed  CAS  Google Scholar 

  4. Eser I, Hyon J, Hose S, O’Brien TP (2004) Comparative antimicrobial efficacy of preserved and preservative-free topical fourth generation fluoroquinolones against various strains of Staphylococcus. Invest Ophthalmol Vis Sci 45:E–Abstract 4921

    Google Scholar 

  5. Ambrosio R Jr, Wilson SE (2001) Complications of laser in situ keratomileusis: etiology, prevention, and treatment. J Refract Surg 17:350–379

    PubMed  Google Scholar 

  6. Tetz MR, Auffarth GU, Sperker M, Blum M, Volcker HE (1997) Evaluation of a photographic image analysis system for posterior capsule opacification scoring. J Cataract Refract Surg 23:1515–1520

    PubMed  CAS  Google Scholar 

  7. Auffarth GU, Golescu A, Becker K, Volcker HE (2003) Quantification of posterior capsule opacification with round and sharp edge intraocular lenses. Ophthalmology 110:772–780 doi:10.1016/S0161–6420(02)01980–2

    Article  PubMed  Google Scholar 

  8. Pollock GA, McKelvie PA, McCarthy DJ, White JF, Mallari PLT, Taylor HR (2003) In vivo effects of fluoroquinolones on rabbit corneas. Clin Experiment Ophthalmol 31:517–521 doi:10.1046/j.1442–9071.2003.00706.x

    Article  PubMed  Google Scholar 

  9. Patel GM, Chuang AZ, Kiang E, Ramesh N, Mitra S, Yee RW (2000) Epithelial healing rates with topical ciprofloxacin, ofloxacin, and ofloxacin with artificial tears after photorefractive keratectomy. J Cataract Refract Surg 26:690–694 doi:10.1016/S0886–3350(00)00411–9

    Article  PubMed  CAS  Google Scholar 

  10. Moreira LB, Lee RF, de Oliveira C, LaBree L, McDonnell PJ (1997) Effect of topical fluoroquinolones on corneal re-epithelialization after excimer laser keratectomy. J Cataract Refract Surg 23:845–848

    PubMed  CAS  Google Scholar 

  11. Ichijima H, Petroll WM, Jester JV, Cavanagh HD (1992) Confocal microscopic studies of living rabbit cornea treated with benzalkonium chloride. Cornea 11:221–225

    Article  PubMed  CAS  Google Scholar 

  12. Rucker I, Kettrey R, Bach F, Zeleznick L (1972) A safety test for contact lens wetting solutions. Ann Ophthalmol 4:1000–1006

    PubMed  CAS  Google Scholar 

  13. De Saint Jean M, Brignole P, Bringuier AF, Bauchet A, Feldmann G, Baudouin C (1999) Effects of benzalkonium chloride on growth and survival of Chang conjunctival cells. Invest Ophthalmol Vis Sci 40:619–630

    PubMed  Google Scholar 

  14. Collin HB, Grabsch BE (1982) The effect of ophthalmic preservatives on the healing rate of the rabbit corneal epithelium after keratectomy. Am J Optom Physiol Opt 59:215–222

    PubMed  CAS  Google Scholar 

  15. Herrygers LA, Noecker RJ, Lane LC, Levine JM (2005) Comparison of corneal surface effects of gatifloxacin and moxifloxacin using intensive and prolonged dosing protocols. Cornea 24:66–71 doi:10.1097/01.ico.0000134182.09569.e1

    Article  PubMed  Google Scholar 

  16. Farley WJ, Luo L, Chen LZ, Stern ME, Pflugfelder SC (2004) Effects of commercial fourth generation fluoroquinolones on corneal epithelial barrier function in experimental murine dry eye. Invest Ophthalmol Vis Sci 45:E–abstract 4904

    Google Scholar 

  17. Kim AS, McCulley JP, Cavanagh HD, Jester JV, Budge AC, Kovoor T, Petrol WM (2003) Evaluation of the effects of topical ophthalmic fluoroquinolones on the cornea using in vivo confocal microscopy. Invest Ophthalmol Vis Sci 44:E–abstract 1367

    Google Scholar 

  18. Gao J, Siemasko KF, Vu C, Etemadi R, McDonnell PJ, Stern E (2004) Effect of the 4th generation fluoroquinolone on rabbit corneal wound healing. Invest Ophthalmol Vis Sci 45:E–Abstract 4889

    Google Scholar 

  19. Barequet IS, Habot-Wilner Z, Lavinsky F, Ziv H, Belkin M, Rosner M (2007) Effect of fourth-generation fluoroquinolones on the healing rate of corneal erosions in an animal model. Cornea 26:606–609

    PubMed  Google Scholar 

  20. Williams KK, Shepard AR, Rice RL, McCartney MD, Wax MB, Hiddemen JW (2007) Corneal wound healing in New Zealand White Rabbits following anterior keratectomy and treatment with moxifloxacin ophthalmic solution 0.5% or gatifloxacin ophthalmic solution 0.3%. J Ocul Pharmacol Ther 23:517–525 doi:10.1089/jop.2007.0008

    Article  PubMed  CAS  Google Scholar 

  21. Burka JM, Bower KS, Vanroekel RC, Stutzman RD, Kuzmowych CP, Howard RS (2005) The effect of fourth-generation fluoroquinolones gatifloxacin and moxifloxacin on epithelial healing following photorefractive keratectomy. Am J Ophthalmol 140:83–87 doi:10.1016/j.ajo.2005.02.037

    Article  PubMed  CAS  Google Scholar 

  22. Solomon R, Donnenfeld ED, Perry HD, Wittpenn JR, Greenman HE, Stein J (2004) The effect of gatifloxacin 0.3% and moxifloxacin 0.5% on corneal epithelial wound healing following photorefractive keratectomy. AAO Annual Meeting, New Orleans, LA, USA

    Google Scholar 

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Acknowledgements

Clinton J. Thompson, Mstat, from the Department of Family & Preventive Medicine, University of Utah, provided assistance with the statistical analyses.

Gamal Saleh, MS, from the Moran Eye Center, University of Utah, assisted with the examinations of study subjects.

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Authors and Affiliations

  1. John A. Moran Eye Center, Old Mill Medical Center, 6360 South 3000 East, Suite 200, Salt Lake City, Utah, 84121, USA

    Majid Moshirfar, Jesse Chew, Liliana Werner, Jay J. Meyer, Brian Hunter, Scott Stevens, Mike Jensen, Guy Kleinmann & Nick Mamalis

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  1. Majid Moshirfar
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  2. Jesse Chew
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  3. Liliana Werner
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  4. Jay J. Meyer
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  8. Guy Kleinmann
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Corresponding author

Correspondence to Majid Moshirfar.

Additional information

Supported in part by a grant to the Department of Ophthalmology at the University of Utah, Salt Lake City, UT, USA from an unrestricted educational grant from Allergan Inc., P.O. Box 19534, Irvine, CA 92623 USA.

The authors have control of all primary data, and agree to allow Graefe's Archive for Clinical and Experimental Ophthalmology to review the data upon request.

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Moshirfar, M., Chew, J., Werner, L. et al. Comparison of the effects of fourth-generation fluoroquinolones on corneal re-epithelialization in rabbit eyes. Graefes Arch Clin Exp Ophthalmol 246, 1455–1461 (2008). https://doi.org/10.1007/s00417-008-0893-5

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  • DOI: https://doi.org/10.1007/s00417-008-0893-5

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