To evaluate the effect of topical sodium hyaluronate (SH) 0.18% treatment on corneal epithelial healing after epithelial debridement in pars plana vitrectomy in diabetic patients.
This is prospective and randomized clinical trial. Our study population included 30 eyes undergoing pars plana vitrectomy that required near total corneal debridement intra-operatively for surgical view. We compared the residual wound and wound healing rate in between 3 groups: 10 diabetic eyes (DMV) on topical SH 0.18%; 10 diabetic eyes (DMC) and 10 non-diabetic eyes (NDM) not treated with topical SH 0.18%. The corneal epithelial wound was measured at 12, 24, 36, 48, 60, 72 and 120 h after the vitrectomy surgery.
DMC group had corneal wounds that reepithelialization significantly more slowly than in NDM and DMV groups at 12, 24, 36 and 48 h (Mann–Whitney test p < 0.05). The epithelial healing rate was significantly faster at 12 h in NDM and DMV group (Mann–Whitney test p < 0.05). No differences in the residual epithelial wound and wound healing were detected in between NDM and DMV groups. The mean for epithelial closure in DMC group was delayed 87.6 ± 28.31 h, compared with DMV group (64.8 ± 21.31) and NDM group (56.4 ± 9.88). All groups were followed up 1 month beyond completed wound closure. No recurrent corneal epithelial wound, corneal melting or corneal neovascularization was noted.
Diabetic patients on SH 0.18% four times daily for epithelial defect had similar corneal wounds healing rate as non-diabetics. This treatment significantly improved corneal wound healing and accelerated complete corneal wound resurfacing in diabetic patients.
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This research was done according to Malaysian Good Clinical Practice (MGCP) 2nd edition January 2004 and was registered with the National Medical Research Register (NMRR) (Research identity: 11322) upon approval of the study by supervisors from institution and university.
Conflict of interest
The authors declare that they have no conflict of interest.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The approval from Research and Ethics Committee, Faculty of Medicine, University Kebangsaan Malaysia and Ministry of Health Malaysia, was obtained (Project code: FF-245-2010). The purpose of the study was explained to the patients in detail. Written consent was obtained from patients at study entry.
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Ling, K., Bastion, M.C. Use of commercially available sodium hyaluronate 0.18% eye drops for corneal epithelial healing in diabetic patients. Int Ophthalmol 39, 2195–2203 (2019). https://doi.org/10.1007/s10792-018-1057-1
- Sodium hyaluronate (SH)
- Corneal epithelium
- Wound healing