Topical N-acetylcysteine reduces interleukin-1-alpha in tear fluid after laser subepithelial keratectomy.
OBJECTIVE
To evaluate the effect of topical N-acetylcysteine (NAC) on interleukin 1-alpha (IL-1alpha) levels in tear fluid after myopic laser subepithelial keratectomy (LASEK) and its possible role in modulating corneal wound healing.


METHODS
Twenty-six eyes of 13 patients who underwent myopic LASEK were divided into 2 groups. Group 1 (n=10 eyes) was used as a control group. All patients received topical lomefloxacin and dexamethasone postoperatively. Additionally, patients in Group 2 received topical NAC for 1 month postoperatively. Tear fluid samples were collected with microcapillary tubes preoperatively, on the first and on the fifth postoperative day, and the release of IL-1alpha in tear fluid was calculated. Haze grading and confocal microscopic examination were performed at 1 and 3 months postoperatively.


RESULTS
The mean IL-1-alpha release values were 0.285-/+0.159 pg/min in Group 1 and 0.235-/+0.142 pg/min in Group 2 preoperatively. In Group 1, the values were 0.243-/+0.155 pg/min on day 1 and 0.164-/+0.125 pg/min on day 5. In Group 2, the mean IL-1alpha release values were 0.220-/+0.200 pg/min on day 1 and 0.080-/+0.079 pg/min on day 5. The difference between the groups was significant only for day 5 (p<0.05). Mean corneal haze score and grey scale value in confocal microscopy were significantly higher (p<0.05) in Group 1 at 1 month. However, at 3 months there was no difference between groups (p>0.05).


CONCLUSIONS
NAC seems to have an additive effect to steroids in suppressing IL-1alpha levels in tear fluid and may be clinically advantageous in modulating corneal wound healing during the early postoperative period after LASEK.
Urgancioglu
Berrak
B
82. Yil State Hospital, Rize - Turkey. bsekeryapan@yahoo.com
Bilgihan
Kamil
K
Engin
Doruk
D
Cirak
Meltem Yalinay
MY
Hondur
Ahmet
A
Hasanreisoglu
Berati
B
D000111:Acetylcysteine / Q000008:administration & dosage*; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D005136:Eye Proteins / Q000378:metabolism; D016166:Free Radical Scavengers / Q000008:administration & dosage*; D006801:Humans; D053582:Interleukin-1alpha / Q000378:metabolism*; D049008:Keratectomy, Subepithelial, Laser-Assisted / Q000379:methods*; D018613:Microscopy, Confocal; D009216:Myopia / Q000378:metabolism / Q000601:surgery*; D011184:Postoperative Period; D011446:Prospective Studies; D013666:Tears / Q000378:metabolism*; D014945:Wound Healing / Q000187:drug effects*; D055815:Young Adult
D005136:Eye Proteins; D016166:Free Radical Scavengers; D053582:Interleukin-1alpha; C042434:tear proteins; D000111:Acetylcysteine