Comparison of Asiatic Acid and Dexamethasone Effect on Interleukin-4 Expression and Eosinophile Cell Count Following Strabismus Surgery: An Experimental Study in New Zealand Rabbit

Introduction: Postoperative strabismus inflammation can lead to fibrotic tissue formation. Dexamethasone, while generally effective as an anti-inflammatory post-surgery medication, can increase IOP and blood sugar levels. Research on asiatic acid suggests its potential as an anti-inflammatory and anti-fibrotic agent. Methods: Superior rectus recession was conducted on 20 rabbits, which were divided into five groups based on the subconjunctival injection substance: aquadest, dexamethasone, asiatic acid at a concentration of 0.4 mg/0.5 mL, 0.8 mg/0.5 mL, and 1.6 mg/0.5 mL. After three days, exenteration was performed, and an immunohistochemical examination was performed to assess interleukin-4 expression. Hematoxylin and eosin staining was performed to assess eosinophile cell count. SPSS 26.0 facilitated the data analysis using the Kruskal-Wallis and Wilcoxon Mann-Whitney tests. P<0.05 was considered significant statistically. Results: This study showed that interleukin-4 expression in the asiatic acid 0.4 mg/0.5 mL group was significantly decreased compared to the aquadest group (P = 0.029) and dexamethasone group (P = 0.029). Higher-dose groups did not exhibit a significant decrease. Dexamethasone also did not exhibit a significant decrease compare to aquadest. There was no significant reduction of eosinophile cell count among all groups. Conclusions: This study highlighted the potential of asiatic acid, particularly at the concentration of 0.4 mg/0.5 mL, in reducing the inflammatory response, specifically interleukin-4 expression, after strabismus surgery in New Zealand rabbits.