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Dexpanthenol/sodium hyaluronate eye drops for corneal epithelial healing following corneal cross-linking in patients with keratoconus

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Abstract

Purpose

To evaluate the effect of dexpanthenol 2%/sodium hyaluronate 0.15% eye drops on corneal epithelial healing and corneal microstructural changes following corneal cross-linking (CXL) in patients with keratoconus.

Methods

The study included 42 eyes of 21 patients with keratoconus who underwent CXL on both eyes. One eye of each patient was instilled dexpanthenol 2%/sodium hyaluronate 0.15% eye drops (DP/SH group) and the fellow eye was instilled unpreserved sodium hyaluronate 0.15% eye drops (SH group). The epithelial healing process was assessed every day until complete reepithelialization was achieved. The in vivo confocal microscopy (IVCM) findings were also recorded.

Results

The mean epithelial defect size 48.6 ± 6.7 mm2 for the DP/SH group and 48.2 ± 5.3 mm2 for the SH group. Complete reepithelialization was seen after 2.24 ± 0.44 days (range 2–4 days) in the DP/SH group and 3.43 ± 0.60 days (3 to 5 days) in the SH group. Posterior keratocyte density and endothelial cell density were similar in both groups. The mean subbasal nerve plexus density was significantly higher in the DP/SH group (postoperative 1 month: 1.13 ± 1.51, 3 months: 3.53 ± 2.55, 6 months: 7.07 ± 1.42) compared to the SH group (postoperative 1 month: 0.87 ± 1.43, 3 months: 2.89 ± 2.62, 6 months 6.33 ± 1.29). The DP/SH group revealed faster subbasal nerve regeneration and less edema compared to the SH group.

Conclusion

Dexpanthenol 2%/sodium hyaluronate 0.15% eye drops were effective and safe for corneal epithelial healing, and promoted faster corneal reepithelialization, nerve regeneration, and keratocyte repopulation with reduced corneal edema compared to sodium hyaluronate eye drops.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors obtained no commercial provider for the investigation, authorship, and broadcasting of the study.

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Authors and Affiliations

  1. Department of Ophthalmology, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

    Huri Sabur

  2. Associate Professor of Ophthalmology, University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey

    Mutlu Acar

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Contributions

HS, MA: designed the study; HS, MA: were involved in patient care; HS, MA: collected the data; HS, MA: analysis and interpretation of data; HS: drafting the manuscript; HS, MA: design of the work, revising the work critically for important intellectual content. All authors approved the final version of manuscript.

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Correspondence to Huri Sabur.

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Conflict of interest

The authors declare they have no financial conflict of interest related to this article.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey and with the 1964 Helsinki declaration and its later amendments or comparable wit ethical standards. Written informed consent was obtained from all individual participants included in the study.

Consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey and with the 1964 Helsinki declaration and its later amendments or comparable wit ethical standards. Written informed consent was obtained from all individual participants included in the study.

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Sabur, H., Acar, M. Dexpanthenol/sodium hyaluronate eye drops for corneal epithelial healing following corneal cross-linking in patients with keratoconus. Int Ophthalmol 43, 3461–3469 (2023). https://doi.org/10.1007/s10792-023-02751-w

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