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Fernández-Ferreiro A, Santiago-Varela M, Gil-Martínez M, Parada TGC, Pardo M, González-Barcia M, Piñeiro-Ces A, Rodríguez-Ares MT, Blanco-Mendez J, Lamas MJ, Otero-Espinar FJ. Ocular safety comparison of non-steroidal anti-inflammatory eye drops used in pseudophakic cystoid macular edema prevention. Int J Pharm 2015; 495:680-91. [PMID: 26423177 DOI: 10.1016/j.ijpharm.2015.09.058] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 09/22/2015] [Accepted: 09/23/2015] [Indexed: 01/09/2023]
Abstract
Non-steroidal anti-inflammatory drug (NSAID) eye drops are widely used to treat ocular inflammatory conditions related to ophthalmic surgical procedures, such as pseudophakic cystoid macular edema, and they have been used for off-label treatments. The most commonly used NSAIDs are diclofenac and ketorolac and the new molecules bromfenac and nepafenac have also been used. We used primary human keratocytes in cell culture in combination with a novel technology that evaluates dynamic real-time cytotoxicity through impedance analysis. This study also included classic cell viability tests (WST-1(®) and AlamarBlue(®)), wound healing assay, Hen's Egg Test and an ex vivo histopathological assay. NSAIDs were shown to have important cytotoxicities and to retard the healing response. Furthermore, the new eye drops containing bromfenac and nepafenac were more cytotoxic than the more classical eye drops. Nevertheless, no immuno-histochemical changes or acute irritation processes were observed after the administration of any eye drops tested. Due to cytotoxicity and the total absence of discomfort and observable injuries after the administration of these drugs, significant corneal alterations, such as corneal melts, can develop without any previous warning signs of toxicity.
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Affiliation(s)
- Anxo Fernández-Ferreiro
- Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Praza Seminario de Estudos Galegos s/n, Santiago de Compostela 1570, Spain; Pharmacy Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Travesía Choupana s/n, Santiago de Compostela 15706, Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS-ISCIII), SERGAS, Travesía da Choupana s/n, Santiago de Compostela 15706, Spain
| | - María Santiago-Varela
- Ophthalmology Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Rua Ramón Baltar s/n, Santiago de Compostela 15706, Spain
| | - María Gil-Martínez
- Ophthalmology Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Rua Ramón Baltar s/n, Santiago de Compostela 15706, Spain
| | - Tomas García-Caballero Parada
- Pathological Anatomy Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Travesía Choupana s/n, Santiago de Compostela 15706, Spain
| | - María Pardo
- Obesidomic Group Instituto de Investigación Sanitaria (IDIS-ISCIII), SERGAS, Travesía da Choupana s/n, Santiago de Compostela 15706, Spain
| | - Miguel González-Barcia
- Pharmacy Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Travesía Choupana s/n, Santiago de Compostela 15706, Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS-ISCIII), SERGAS, Travesía da Choupana s/n, Santiago de Compostela 15706, Spain
| | - Antonio Piñeiro-Ces
- Ophthalmology Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Rua Ramón Baltar s/n, Santiago de Compostela 15706, Spain
| | - María Teresa Rodríguez-Ares
- Ophthalmology Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Rua Ramón Baltar s/n, Santiago de Compostela 15706, Spain
| | - José Blanco-Mendez
- Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Praza Seminario de Estudos Galegos s/n, Santiago de Compostela 1570, Spain; Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Praza Seminario de Estudos Galegos s/n, Santiago de Compostela 15701, Spain
| | - M J Lamas
- Pharmacy Department, Xerencia de Xestión Integrada de Santiago de Compostela, SERGAS, Travesía Choupana s/n, Santiago de Compostela 15706, Spain; Clinical Pharmacology Group, Health Research Institute of Santiago de Compostela (IDIS-ISCIII), SERGAS, Travesía da Choupana s/n, Santiago de Compostela 15706, Spain
| | - Francisco J Otero-Espinar
- Pharmacy and Pharmaceutical Technology Department, Faculty of Pharmacy, University of Santiago de Compostela (USC), Praza Seminario de Estudos Galegos s/n, Santiago de Compostela 1570, Spain; Industrial Pharmacy Institute, Faculty of Pharmacy, University of Santiago de Compostela (USC), Praza Seminario de Estudos Galegos s/n, Santiago de Compostela 15701, Spain.
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