Arachidonic Acid Metabolites After Excimer Laser Corneal Surgery

We investigated early mediators of inflammation following excimer laser ablation in a rabbit cornea model. The ability of topical anti-inflammatory agents to influence these responses was also examined. Adult New Zealand white rabbits were subjected to photorefractive keratectomy with a 193-nm argon fluoride excimer laser. Prostaglandin E₂ and leukotriene B₄ levels were measured using an enzyme immunoassay, and leukocyte infiltration was determined histologically. Prostaglandin E₂ production was rapid and sustained, but we were unable to detect the presence of leukotriene B₄. Relative to control, postoperative topical diclofenac sodium treatment caused a significant decrease in prostaglandin E₂ levels and a significant increase in corneal leukocytes at 10 hours. Fluorometholone treatment did not significantly alter prostaglandin E₂ levels but markedly depressed leukocyte ingress. Diclofenac reduces prostaglandin E₂ levels but not leukocyte infiltration in the cornea following photorefractive keratectomy and thus may be useful clinically to reduce postsurgical pain.