Stimulating re-epithelialization after photorefractive keratectomy.
BACKGROUND
Re-epithelialization is usually complete in eyes 3 to 4 days following photorefractive keratectomy (PRK). However, this process is delayed in 0.5% of these eyes, leading to early development of haze. The authors investigated a method to stimulate re-epithelialization following PRK.


METHODS
PRK was performed with the Nidek EC-5000 excimer laser. Following surgery, express-cytokinotherapy was applied. This method consisted of a single subconjunctival injection of 2.5 to 3.0 ml of ex juvanticus mixture of autoblood and immunomodulator Poludan. This mixture was then applied topically 4 times a day until re-epithelialization was complete. Poludan is an interferon inducer (complex polyA: polyU), stimulates expressed production of interferon and interleukin-2, and increases natural cytotoxicity.


RESULTS
Thirty eyes of 30 patients with delayed re-epithelialization were treated with the described method. The average time to re-epithelialization was 7.00 + 0.64 days. Total epithelialization was complete on day 3 + 0.38 after beginning the cytokinotherapy (P < .05). Early haze developed in only 2 patients from this group. Occurrence of early haze in the control group of patients who had persistent epithelial defects 8 to 16 days postoperatively and were given traditional therapy--including corticosteroid and non-steroidal drugs--was reliably higher: 8 to 10 days (P < .01).


CONCLUSIONS
Local express-cytokinotherapy appears to be an effective method to promote quick and complete epithelialization in eyes following PRK that experience delayed re-epithelialization. This treatment may be an important part of the prevention of early haze development and achievement of better visual acuity.
Kourenkov
V V
VV
New Line Vision Ophthalmology Research Center, Moscow, Russia.
Mytiagina
O N
ON
Kasparov
A A
AA
Pavluk
A G
AG
D000328:Adult; D001769:Blood; D004847:Epithelial Cells / Q000502:physiology; D019573:Epithelium, Corneal / Q000187:drug effects*; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000601:surgery; D007369:Interferon Inducers / Q000627:therapeutic use*; D054018:Lasers, Excimer; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D018903:Photorefractive Keratectomy; D011131:Polyribonucleotides / Q000627:therapeutic use*; D015203:Reproducibility of Results; D016896:Treatment Outcome; D014792:Visual Acuity; D014945:Wound Healing / Q000187:drug effects*
D007369:Interferon Inducers; D011131:Polyribonucleotides; C044366:poludan