Randomized Clinical Trial of Topical Sodium Hyaluronate After Excimer Laser Photorefractive Keratectomy

Abstract

BACKGROUND: Sodium hyaluronate (Healon) has been reported to promote corneal epithelial healing following severe eye burns in humans and rabbits. Endogenous hyaluronate has been shown to be significantly increased in the corneal tissue following extracapsular lens extraction, anterior segment trauma, and radial keratotomy. The authors report the use of topical sodium hyaluronate administration on the cornea of eyes which have been treated by photorefractive keratectomy for myopia. METHODS: Forty eyes of 40 patients undergoing excimer laser photorefractive keratectomy for myopia were studied to evaluate the effect of topical sodium hyaluronate versus placebo (Healon buffer) instillation on pain and corneal epithelial healing in an observer blind randomized clinical trial. RESULTS: There was no significant difference between patients whose eyes were treated with sodium hyaluronate and those treated with a placebo (Healon buffer), with regard to the amount of postoperative pain or the rapidity of corneal epithelial healing. CONCLUSIONS: Topical sodium hyaluronate administration showed no effect on pain or corneal epithelial healing following photorefractive keratectomy in this study. [JRefìract Surg. 1995;11:42-44.]

Sodium hyaluronate (hyaluronic acid) promotes migration of human corneal epithelial cells in vitro

“…On the other hand, in one prospective study comparing SH with placebo in patients undergoing photorefractive surgery, no difference was noted. 48 Experimental data obtained from the rabbit model of corneal epithelial wound healing has some limitations: (1) rabbit corneal epithelial cells have different proliferation rates, (2) rabbit corneal epithelial cells undergo a different differentiation process, based on the analysis of specific cytokeratin expression, 49 (3) rabbit corneal epithelial cells have a more cohesive adherence to fibronectin (in contrast with human corneal epithelial cells) that adheres better to laminin, and (4) rabbit cornea has a different structure from human cornea in that it is thinner and does not possess a Bowman's layer. 50 51 The results obtained from rabbit studies with regard to the effect of SH cannot therefore be directly applicable to human corneal epithelial wound healing.…”

Wide Use of Hyaluronic Acid in the Process of Wound Healing—A Rapid Review

“…In summary, HA is a versatile biomaterial with large applicability in various fields of medicine for its antioxidant, anti-inflammatory, antibacterial properties, and it accelerates healing [109][110][111][112][113][114][115]. Our review analyzed its wide range of applications, along with promising results of numerous studies, emphasizing its important role in the management of hard-to-heal wounds.…”

Laser epithelial keratomileusis in 2010 – a review

“…Intraoperative cooling of the eye using cold‐balanced salt solution has been shown to have a beneficial effect on postoperative pain 33 as have bandage contact lenses. Placement of Visthesia 34 or Healon 35 in the eye on completion of the laser has not shown any effect when compared with placebo. Administration of large doses of systemic steroids preoperatively and shortly after surgery has been suggested, but there are no published studies to show that they have any beneficial affect.…”