Enhanced corneal wound healing with hyaluronic acid and high‐potassium artificial tears

Abstract

Background:The aim of this study was to investigate the therapeutic role of preservative-free artificial tears containing hyaluronic acid and high potassium ion concentration (HA/ high-K artificial tears) on mechanically scraped or alkali-induced corneal epithelial defects in rats. Methods: We created mechanically scraped epithelial defects on the corneas of 24 SpragueDawley (SD) rats (three groups of eight rats) and alkali-induced epithelial defects on the corneas of 27 SD rats (three groups of nine rats). Then we applied topical 0.3 per cent or 0.15 per cent HA/high-K artificial tears four times daily for 1.5 days and compared its effect with that of topical phosphate buffered saline (PBS). The fluorescein staining analysis and histological examination were performed immediately after and at 12, 24 and 36 hours after injury. Results:In the mechanical scraping model, the areas of fluorescein staining in the eyes after topical application of 0.3 per cent HA/high-K artificial tears were significantly smaller than those after PBS treatment at 12 and 24 hours after injury. At 36 hours, the staining areas of both 0.3 per cent and 0.15 per cent HA/high-K artificial tears-treated eyes were found to be significantly smaller than those of the PBS-treated eyes. In the alkali burn model, the promotion of corneal epithelial wound healing after treatment with 0.3 per cent and 0.15 per cent HA/high-K artificial tears was not significantly different compared to that after treatment with PBS. Conclusion: Hyaluronic acid and high potassium ion concentration artificial tears promoted corneal epithelial wound healing in the mechanical scraping model; however, in the alkali burn model, no significant beneficial effect of this treatment was observed.

Comparison of 0.2% and 0.18% hyaluronate eye drops in patients with moderate to severe dry eye with keratitis or keratoconjunctivitis

“…HA eye drops may be promoting OS tissue healing by humidifying the OS, thus bringing back the integrity of corneal and conjunctival epithelium. It has been shown that topically applied HA stimulates wound healing in an animal model25 and attenuates oxidative stress and inflammation, thus improving dry eye symptoms 26…”

Effects of topical hyaluronic acid on corneal wound healing in dogs: a pilot study

“…The addition of hyaluronic acid to standard therapy for canine corneal ulceration is controversial among veterinary ophthalmologists. Results of previous studies performed in other species suggest that hyaluronic acid accelerates epithelial corneal wound healing when compared to saline control . The results of this study found no difference in corneal re‐epithelialization after superficial ulceration in dogs.…”

“…Hyaluronic acid serves other important biologic roles, including the ability to promote wound healing. Numerous studies have demonstrated that hyaluronic acid accelerates corneal wound healing both in vitro and in vivo . Consequently, topical hyaluronic acid is commonly included in the treatment regimen for superficial corneal ulcerations in canine patients.…”

Hyaluronic Acid in the 3^rd Millennium

“…Many studies have proved the safety and the efficacy of native HA solutions as artificial tears [222,[224][225][226]. More recently, also novel derivatives of hyaluronan with improved mechanical and biological properties are being investigated to formulate eye drops with enhanced ocular residence times.…”