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 E₂ 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 E₂ and leukotriene B₄ were detected by enzyme- linked immunoassay, and leukocyte infiltration was determined histologically. Results: Prostaglandin E₂ and leukocyte infiltration in creased in the cornea after excimer ablation. Treatment with topical fluorometholone and diclofenac sodium significantly reduced prostaglandin E₂ levels. Corneas treated with diclofenac had significantly higher levels of leukocyte infiltration than those treated with ketorolac tromethamine. No changes in leukotriene B₄ levels were detected in this model. Conclusions: As a group, topical anti-inflammatory medications tend to lower prostaglandin E₂ 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.