Topical Interleukin-1 receptor antagonist therapy and corneal healing after photorefractive keratectomy in New Zealand White rabbits Brett Davies, Capt,

Topical Interleukin-1 receptor antagonist therapy and corneal healing after photorefractive

keratectomy in New Zealand White rabbits

Brett Davies, Capt, USAF, MC; Vasudha Panday, Maj, USAF, MC; Charles Reilly, Lt Col, USAF, MC ; Matthew Caldwell, Maj,

USAF, MCWilford Hall Air Force Medical Center

San Antonio, TX

The authors have no financial interest to discloseTopical IL-1ra provided by TheraKine, Inc.The conclusions do not necessarily reflect the views of the USAF or the DOD

ASCRS 2010, Boston, MA

Purpose This is a randomized, blinded study designed to compare topical

Interleukin-1 antagonist (IL-1ra) against standard steroid treatment following photorefractive keratectomy (PRK).

Vs

SteroidsGlaucomaCataractsSecondary infectionDelayed wound healing

Interleukin-1

Methods

48 eyes

18 (OD)IL-1ra

Vigamox

6OD 2.5mg

6 OD1.25 mg

6 OD0.75mg

6 (OD)Flurometh

0.1%, Vigamox

24 OS Vigamox, Systane

Outcome Measures Time to re-epithelization

Weekly slit lamp exam for haze

Pentacam evaluation prior to and at weeks 1,2,3, and 7

Histologic exam at week 7

Results

No difference in epithelial healing time

Time to re-epithelization:

Results- Slit lamp exam

Week 3 Week 4 Week 5 Week 60

0.5

1

1.5

2

2.5

3

3.5

SteroidIL-1raControl

p=0.392

p<0.005 p<0.005

p=0.536

Su

bje

ctiv

e H

aze

Results- Pentacam Haze

Week 1 Week 2 Week 3 Week 740

50

60

70

80

90

100

0.25mg1.25mg2.5mg

Den

sit

y

p<0.0001

Results-HistologySteroids 2.5mg 1.25mg 0.25mg

Central Foam Layer

p = 0.725

Thickest Foam Layer

p = 0.997

Conclusions

Against For

Epithelial healing

Histopathology

Pentacam

Side effects?

Subjective

Further studies needed to determine side effects of IL-1ra as well as response in human cornea

IL-1ra does not increase epithelial healing timeNo difference in foam layer between treatment groupsSteroids significantly better than other groups on subjective haze analysis at weeks 4 and 5IL1-ra reduced objective haze (Pentacam) similar to steroids at 1 month post op

Lower doses of IL1-ra reduced objective haze more than higher dose

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