Effects of artificial tears on rabbit ocular surface healing after exposure to benzalkonium chloride

The aim of the study was to observe the effect of different artificial tears on healing the drug-induced keratopathy. To this aim, 64 rabbits received topical administration of 0.01% benzalkonium chloride to establish models and were divided into four groups. The control group received ocular saline solution (Saline), while the others were treated with Refresh Plus® (RF), Hycosan® (H) and Systane® Ultra (SU). Surface abnormalities were examined daily using slit-lamp. Fluorescein staining, histopathological and transmission electron microscopic (TEM) examination were performed at day 0, 2 weeks, and 1 and 2 months. A significant difference was observed between RF and SU, but not between H and SU at 2 weeks. TEM examination revealed new microvilli close to the cavity surface, and the number of microvilli in SU was greater than in H at 2 weeks and 1 month. Based on the results, the effect in the SU group was the most significant. Eye drops with nontoxic preservative such as SU are an alternative to treat drug-induced keratopathy.