Neuroprotective effects of ketamine, lamotrigine, and ketoprofen combinations after pars plana vitrectomy and silicone oil injection

Abstract

Abstract Purpose This experimental study aims to assess the protective impact of combined treatment with ketamine (KTM), lamotrigine (LMT), and ketoprofen (KTP), agents that have demonstrated neuroprotective properties in other experimental contexts, on rabbit retinas in an experimental model of pars plana vitrectomy (PPV) and silicone oil injection (SOI). Methods Thirty-six rabbits were divided into six treatment groups: saline, KTP, KTM+LMT, KTM+KTP, LMT+KTP, and KTM+LMT+KTP. All rabbits underwent PPV and SOI in the right eye. The left eyes served as negative controls. Histological assessments were conducted to evaluate cell densities and structural changes in the ganglion cell layer (GCL), the inner nuclear layer (INL), and the outer nuclear layer (ONL). Apoptosis was evaluated using the TUNEL method. Results The KTP group exhibited reduced apoptosis and partial protection in all retinal layers. The KTM+LMT combination significantly protected the GCL. The KTM+KTP group showed notable protection in the INL. The LMT+KTP combination was effective for both the INL and GCL. The KTM+LMT+KTP combination provided the most comprehensive protection across the ONL and INL. The cell densities in the ONL, INL, and GCL were significantly greater in the treatment groups than in the positive control group. Conclusion The combination of KTM, LMT, and KTP exhibited significant neuroprotective effects on rabbit retinas following PPV and SOI. These findings suggest the potential of this combination treatment as a therapeutic strategy for retinal pathologies.