A comparison of Fluoracaine and Fluorox on corneal epithelial cell desquamation after Goldmann Applanation Tonometry.

BACKGROUND

The purpose of this study was to quality the frequency and amount of corneal desquamation from a sodium fluorescein/proparacaine combination (Fluoracaine) as compared with sodium fluorescein/benoxinate combination ophthalmic solution (Fluorox) after Goldmann Applanation Tonometry.

METHODS

One drop of Fluoracaine was randomly instilled into one eye and one drop of Fluorox was instilled into the opposite eye of the same patient. Intraocular pressures (IOPs) by GAT and tear break-up times (TBUTs) were taken. Corneal stinging was compared. Corneal integrity by Cornea and Contact Lens Research Unit (CCLRU) standards was evaluated at 0, 3, 7, 10, 15, and 20 minutes after instillation of the ophthalmic solutions.

RESULTS

Sixty eyes of 30 patients were observed Forty-seven percent of the patients reported Fluorox to string more than Fluoracaine; 23% of the patients reported that Fluoracaine stings more than Fluorox; and 30% the patients reported no difference. Average TBUTs were 6.87 and 7.17 seconds with Fluoracaine and Fluorox, respectively. Fluoracaine produced micro- and macropunctate keratitis of the superficial epithelium in 31% to 45% of the cornea. Fluorox caused superficial micropunctate keratitis in about 16% to 30% of the cornea. At 20 minutes, all eyes with Fluoracaine and all eyes but one with Fluorox had corneal desquamation.

CONCLUSIONS

Fluoracaine causes marginally less stinging--however, clinically and statistically more corneal desquamation--than Fluorox after GAT. Corneal integrity after use of Fluoracaine should be evaluated even 20 minutes after GAT procedures for corneal disruption.