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ASCRS Comparison of the effects of fourth-generation fluoroquinolones on epithelial healing after PRK PowerPoint PPT Presentation


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Neither of authors has a financial or proprietary interest in any material or method mentioned. ASCRS Comparison of the effects of fourth-generation fluoroquinolones on epithelial healing after PRK. Department of Ophthalmology College of Hallym University

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ASCRS Comparison of the effects of fourth-generation fluoroquinolones on epithelial healing after PRK

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Neither of authors has a financial or

proprietary interest in any material or

method mentioned.

ASCRS Comparison of the effects of fourth-generation fluoroquinolones on epithelial healing after PRK

Department of Ophthalmology

College of Hallym University

Hallym Medical Center Seoul, South Korea

Jung Hwan Shin MD

Ha Bum Lee MD

Hye Young Park MD


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Introduction

Fluoroquinolones, with excellent broad-spectrum coverage and good ocular tolerance, have been frequently used as prophylactic agents both for traumatic corneal erosions and in refractive surgery.

Fourth Generation

Third Generation

Second Generation

  • Moxifloxacin

  • Gatifloxacin

  • Grepafloxacin

  • Levofloxacin

  • Ciprofloxacin

  • Lomefloxacin

  • Norfloxacin

  • Ofloxacin


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Introduction

  • Good ocular penetration

  • Improved penetration

  • into ant. chamber

  • Broad spectrum of activity

  • - more susceptible of

  • gram-positive orginism

  • Atypical mycobacteria

  • coverage

4th generation fluoroquinolones advantage

Better MIC90

(minimum inhibitory concentration 90s)

Less resistance

BUT, may inhibit corneal wound healing


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Introduction

One study showed Comparison of Zymar and Vigamox

on clinical setting(post PRK) 

Their study suggests that Vigamox has a more favorable epithelial healing profile in a post PRK

But, because of Zymar is contained BAK,

it is not a same condition.


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Purpose

To compare the effects on epithelial healing of gatifloxacin and moxifloxacin used for antimicrobial prophylaxis following photorefractive keratectomy (PRK)

Preservative-free

Preservative-free


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Double-masked

randomized

prospective trial

Design

Forty-four patients undergoing PRK(photorefractive keratectomy)

with 7mm epithelial defect

Subject

Received gatifloxacin(Gatiflo® 0.3%, no preservative) in one eye and moxifloxacin(Vigamox® 0.5%, no preservative) in fellow eye

for prophylactic antibiotics

Method

Subjects and methods

MEL80

Mean epithelial healing time

Mean defect size

Pain score

Outcome


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Subjects and methods

Ex.

POD #2

POD #3

POD #1

Defect calculation

(pixels)

:using Adobe photoshop CS3

OD Gatiflo®

28164 pixels

4371 pixels

0 pixels

OS Vigamox®

2017 pixels

0 pixels

25793 pixels

  • Data analysis

    • Mann-Whitney U test

    • SPSS 12.0 (SPSS Inc., USA)

    • p value < 0.05


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Results


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Results

[Table 1] The mean epithelial healing time and mean defect size

No significant difference

in the effects of fourth-generation fluoroquinolones


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Results

[Table 2] Vision(VA & BCVA) of POD #90 and pain score

Pain score(0~4)

0 no pain         1     mild             2     discomforting(burning sense)   3     distressing(need analgesic)     4     excruciating(not subside

despite analgesic)

No significant difference

in the effects of fourth-generation fluoroquinolones


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Discussion

This result carries an important meaning because both eye drops we used are preservative-free.

This study demonstrated that

the commercial ophthalmic formulations of moxifloxacin(Vigamox®) and gatifloxacin(Gatiflo®)

were similar to each other in their effects on rates of corneal wound re-epithelialization.


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ASCRS Thank you for your attention


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