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 rabbits were subjected to phototherapeutic keratectomy with a commercially available excimer laser. Prostaglandin E 2 and leukotriene B 4 were detected by enzyme-linked immunoassay, and leukocyte infiltration was determined histologically. Results: Prostaglandin E 2 and leukocyte infiltration increased in the cornea after excimer ablation. Treatment with topical fluorometholone and diclofenac sodium significantly reduced prostaglandin E 2 levels. Corneas treated with diclofenac had significantly higher levels of leukocyte infiltration than those treated with ketorolac tromethamine. No changes in leukotriene B 4 levels were detected in this model. Conclusions: As a group, topical anti-inflammatory medications tend to lower prostaglandin E 2 levels in rabbit corneas subjected to excimer ablation, but differ in their ability to reduce polymorphonuclear leukocyte infiltration. Further work is needed in this model to understand how these drugs alter leukocyte infiltration of the remaining stromal bed.