Yonsei Med J.  2014 Jan;55(1):197-202. 10.3349/ymj.2014.55.1.197.

Epithelial Wound Healing after Cataract Surgery Comparing Two Different Topical Fluoroquinolones

• Han KE
• Chung WS
• Kim TI
• Kim S
• Kim T
• Kim EK

• KMID: 1779906
• DOI: http://doi.org/10.3349/ymj.2014.55.1.197

Abstract

PURPOSE
To compare the epithelial wound healing response of two preservative-free fluoroquinolones, moxifloxacin and levofloxacin, in patients who underwent cataract surgery.
MATERIALS AND METHODS
In this prospective, evaluator-masked, randomized clinical trial, 59 eyes of 50 patients who underwent cataract surgery were enrolled. Patients were randomized to receive moxifloxacin 0.5% (n=32 eyes) or levofloxacin 0.5% (n=27 eyes). All patients instilled moxifloxacin or levofloxain four times daily for 1 week prior to surgery and 2 weeks after surgery. The epithelial wound healing status in the corneal incision site was scanned with a raster scan mode of fourier-domain optical coherence tomography (FD-OCT). The number of eyes showing epithelial defect images and average number of corneal epithelial defect cuts per eye were compared between groups. All patients were evaluated on postoperative days 1, 2, 3, and 10.
RESULTS
On postoperative days 1, 2, and 3, the number of eyes showing epithelial defects in FD-OCT was not statistically different (all p>0.05). The average number of corneal epithelial defect cuts was also not statistically different between the two groups (all p>0.05). No eyes showed epithelial defects on postoperative day 10 in either group.
CONCLUSION
There were no differences on epithelial wound healing comparing these two different fluoroquinolones at the incision site of cataract surgery.

Keyword

Levofloxacin; moxifloxacin; cataract surgery; epithelial wound healing

MeSH Terms

Aged
Aza Compounds/therapeutic use
Cataract Extraction
Cornea/drug effects/*surgery
Female
Fluoroquinolones/*therapeutic use
Humans
Levofloxacin/therapeutic use
Male
Middle Aged
Quinolines/therapeutic use
Tomography, Optical Coherence
Wound Healing/*drug effects
Aza Compounds
Fluoroquinolones
Levofloxacin
Quinolines

Figure

• 

  Fig. 1 (A) A slit lamp photograph of the corneal incision after fluorescence dye staining. The margin of corneal defect is obscure (a or b) and can be interpreted differently according to varying strengths of illumination. (B) A capture window of raster scan mode in fourier-domain optical coherence tomography (FD-OCT). By selecting a 3×3 mm2 sized capture window, 17 cuts of cross-sectional images (white and red arrows) could be acquired at the same gap. (C) On cross-sectional images of red arrows in Fig. 1B, the defect cuts (C-1 to 4) can be counted. The actual margin of corneal defect detected based on the FD-OCT images was determined to be "a" not "b" in Fig. 1A.

• 

  Fig. 2 (A) Representative images showing the defect and non-defect image cuts in images of the fourier-domain optical coherence tomography. (A and B) An imaginary line (red dotted line) was drawn connecting Bowman layer on both ends of the sectional plane. (A-1 and A-2) Cases showing a lack of epithelium on the imaginary line and a discontinuation of this line were interpreted as a defect cut. The black hollow spaces without epithelial growth were noted (white arrows). The layer of powerfully bright light is considered to be a reflection of the tear fluid (white hollow arrowheads). (B-1 and B-2) Cases showing epithelial growth both above this line and without interruptions were interpreted as a non-defect image cut. The spaces in the incision site were occupied with epithelial growth which showing similar dark gray color with the epithelial layer (black arrows).

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