Effect of Diclofenac on Corneal Haze after Photorefractive Keratectomy in Rabbits

Purpose: To evaluate the ability of topical diclofenac to decrease corneal opacity after excimer laser photorefractive keratectomy (PRK). Methods: Twenty New Zealand white rabbits underwent a unilateral 193-nm excimer laser myopic photorefractive keratectomy to correct 5 diopters. There were four groups of five rabbits each. The first group of rabbits received postoperative topical treatment with placebo (Voltaren Ophthalmic vehicle), the second group received topical 0.1 diclofenac, the third group received topical corticosteroid (0.1% fluorometholone), and the fourth group received diclofenac and fluorometholone. In the first month, the topical drugs were applied four times daily, and in the second month twice daily. Corneal haze was graded from 0 (totally clear) to 4 (completely opaque cornea). Slit-lamp pictures were obtained at weeks 2, 4, and 8, and keratometry readings was performed at weeks 4 and 8. At week 8, the rabbits were killed, and the eyes were submitted for histologic examination. Results: At week 8, there was less corneal haze in the diclofenac-treated animals and in the fluorometholone-treated animals than in the control group, but only in the diclofenac-treated group was the difference statistically significant. Combination treatment with diclofenac and fluorometholone did not result in a further decrease in haze. Conclusions: These data suggest that diclofenac and fluorometholone may influence corneal wound healing in rabbits after excimer laser PRK and support a potential role for using topical nonsteroidal anti-inflammatory drugs in preventing the development of excessive corneal haze after excimer laser surgery.