This study investigated the toxicity of commercial non-steroid anti-inflammatory drug (NSAID) eye solutions against corneal epithelial cells in vitro. The biologic effects of 1/100-, 1/50-, and 1/10-diluted bromfenac sodium, pranoprofen, diclofenac sodium, and the fluorometholone on corneal epithelial cells were evaluated after 1-, 4-, 12-, and 24-hr of exposure compared to corneal epithelial cell treated with balanced salt solution as control. Cellular metabolic activity, cellular damage, and morphology were assessed. Corneal epithelial cell migration was quantified by the scratch-wound assay. Compared to bromfenac and pranoprofen, the cellular metabolic activity of diclofenac and fluorometholone significantly decreased after 12-hr exposure, which was maintained for 24-hr compared to control. Especially, at 1/10-diluted eye solution for 24-hr exposure, the LDH titers of fluorometholone and diclofenac sodium markedly increased more than those of bromfenac and pranoprofen. In diclofenac sodium, the Na+ concentration was lower and amount of preservatives was higher than other NSAIDs eye solutions tested. However, the K+ and Cl- concentration, pH, and osmolarity were similar for all NSAIDs eye solutions. Bromfenac and pranoprofen significantly promoted cell migration, and restored wound gap after 48-hr exposure, compared with that of diclofenac or fluorometholone. At 1/50-diluted eye solution for 48-hr exposure, the corneal epithelial cellular morphology of diclofenac and fluorometholone induced more damage than that of bromfenac or pranoprofen. Overall, the corneal epithelial cells in bromfenac and pranoprofen NSAID eye solutions are less damaged compared to those in diclofenac, included fluorometholone as steroid eye solution.
Purpose: Periocular carbon dioxide ultrapulsed laser surgery can induce ocular damage. Herein we report a rare case of corneal burn after carbon dioxide ultrapulsed laser for nevus removal. Case summary: A 25-year-old female patient presented with ocular pain, decreased visual acuity, and metamorphopsia in the left eye after laser surgery for nevus removal at a dermatology clinic 4 days prior. The patient's best corrected visual acuity in the left eye was 20/100. Central corneal haziness and corneal epithelial defect were observed on biomicroscopic examination. Antibiotics, steroid and artificial tear eye drops were administered for treatment. Glasses were prescribed to correct refraction errors. After 2 months of treatment, the best corrected visual acuity in the left eye recovered to 20/50, and corneal epithelial defect was mostly healed, however corneal haziness remained. Conclusions: Carbon dioxide ultrapulsed laser is commonly used in dermatological treatments. The use of an eye shield is important during this procedure, and possibility of ocular surface damage from laser treatment should be considered. J Korean Ophthalmol Soc 2014;55(9):1376-1379
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