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, MC Wilford Hall Air Force Medical Center San Antonio, TX The authors have no financial interest to disclose Topical 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

Steroids Glaucoma Cataracts Secondary infection Delayed wound healing

Interleukin-1

Methods 48 eyes 18 (OD) IL-1ra Vigamox 6OD 2.5mg 6 OD 1.25 mg 6 OD 0.75mg 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 p=0.392 p<0.005 p=0.536 Subjective Haze

Results- Pentacam Haze p<0.0001

Results-Histology Steroids2.5mg1.25mg0.25mg Central Foam Layer p = Thickest Foam Layer p = 0.997

Conclusions AgainstFor Epithelial healing HistopathologyPentacamSide 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 time No difference in foam layer between treatment groups Steroids significantly better than other groups on subjective haze analysis at weeks 4 and 5 IL1-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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