State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China .
Cornea. 2021 Oct 1;40(10):1248-1252. doi: 10.1097/ICO.0000000000002625.
Traumatic corneal abrasion (TCA) causes damage to both corneal epithelium and the underlying hemidesmosomal junctions. Delayed recovery of hemidesmosomal junctions causes symptomatic episodes. However, there is no recommended treatment for recovery of hemidesmosomal junctions, indicating that a blank period exists in TCA treatment. In this study, the efficacy of long-term use of sodium hyaluronate on recovery of hemidesmosomal junctions during the blank period in TCA healing was investigated.
In this prospective, randomized control pilot study, 60 patients with TCA were enrolled. The patients were randomized 1:1 to receive 0.3% sodium hyaluronate eye drops for 3 months (HA group) or observation alone (control group) after complete corneal epithelium recovery. The primary and secondary outcomes were the cumulative incidence of major and minor symptomatic episodes during a 12-month follow-up, respectively.
Fifty-six subjects (29 in the HA group and 27 in the control group) completed the 12-month follow-up. The 12-month cumulative incidence rate of major symptomatic episodes was 20.7% in the HA group and 18.5% in the control group. No significant difference was found between the 2 groups (P = 0.838). The 12-month cumulative incidence rate of minor symptomatic episodes was 48.3% and 37.0% in the HA and control groups, respectively, with no significant difference (P = 0.397).
Approximately one-fifth of patients with TCA experience major symptomatic episodes again within their 1-year follow-up. Long-term use of sodium hyaluronate in the period of recovery of hemidesmosomal junctions has no benefit to it.
外伤性角膜擦伤(TCA)会同时损伤角膜上皮和基底半桥粒连接。半桥粒连接的延迟恢复会导致症状性发作。然而,目前尚无推荐的治疗方法来恢复半桥粒连接,这表明 TCA 治疗存在空白期。本研究旨在探讨在 TCA 愈合的空白期内,长期使用透明质酸钠对恢复半桥粒连接的疗效。
这是一项前瞻性、随机对照的初步研究,共纳入 60 例 TCA 患者。患者按 1:1 随机分为接受 0.3%透明质酸钠滴眼液治疗 3 个月(HA 组)或单纯观察(对照组)。主要和次要结局分别为 12 个月随访期间主要和次要症状性发作的累积发生率。
56 例患者(HA 组 29 例,对照组 27 例)完成了 12 个月的随访。HA 组和对照组 12 个月主要症状性发作的累积发生率分别为 20.7%和 18.5%,差异无统计学意义(P = 0.838)。HA 组和对照组 12 个月次要症状性发作的累积发生率分别为 48.3%和 37.0%,差异无统计学意义(P = 0.397)。
大约五分之一的 TCA 患者在 1 年随访期间再次出现主要症状性发作。在半桥粒连接恢复期间长期使用透明质酸钠对其并无益处。