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Effect of topical antibiotic solutions on corneal epithelial wound healing
Abstract:
The eight topical antibiotic solutions that we use most frequently were tested for their effect on corneal epithelial wound healing in the rabbit. Five percent cefazolin sodium and a mixture of neomycin sulfate, polymyxin B sulfate, and gramicidin (Neosporin) had the least effect on epithelial healing rates and quality of healing, 10% sulfacetamide sodium and an artificial tear had intermediate effects, and gentamicin sulfate, tobramycin, and chloramphenicol were the most toxic. No substantial differences were found between gentamicin and the newer aminoglycoside, tobramycin, and the "fortified" preparations of these two drugs did not seem to be more toxic than the 0.3% solutions. Therefore, topical antibiotic solutions vary in their effects on the corneal epithelium, and not all antibiotics should be considered innocuous when used in the treatment of epithelial defects.
Insights
Topical antibiotics significantly impact corneal healing. Cefazolin sodium and Neosporin showed minimal toxicity, while gentamicin, tobramycin, and chloramphenicol were most harmful to the corneal epithelium.
Area of Science:
- Ophthalmology
- Wound Healing
- Pharmacology
Background:
- Topical antibiotics are crucial for managing ocular infections and preventing complications.
- The potential impact of commonly used topical antibiotics on corneal wound healing is not fully understood.
- Assessing the differential effects of these agents is vital for clinical decision-making.
Purpose of the Study:
- To evaluate the in vivo effects of eight frequently used topical antibiotic solutions on corneal epithelial wound healing in a rabbit model.
- To compare the toxicity and healing outcomes associated with different antibiotic classes and concentrations.
Main Methods:
- An in vivo rabbit corneal epithelial wound model was utilized.
- Eight common topical antibiotic solutions were applied.
- Corneal epithelial healing rates and quality were assessed post-application.
Main Results:
- Cefazolin sodium (5%) and a neomycin/polymyxin B/gramicidin combination (Neosporin) demonstrated the least detrimental effects on healing.
- Gentamicin sulfate, tobramycin, and chloramphenicol exhibited the highest toxicity to the corneal epithelium.
- Sulfacetamide sodium (10%) and artificial tears showed intermediate effects.
- No significant difference in toxicity was observed between gentamicin and tobramycin, nor between standard and fortified preparations.
Conclusions:
- Topical antibiotic solutions possess varying degrees of toxicity to the corneal epithelium.
- Not all antibiotics are equally safe for use in treating corneal epithelial defects.
- Clinical selection of topical antibiotics should consider their potential impact on corneal healing and toxicity.