Özkan Gamze, Turhan Semra Akkaya, Toker Ebru
Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey
Ophthalmology, Marmara University School of Medicine, Istanbul, Turkey.
BMJ Open Ophthalmol. 2025 Mar 29;10(1):e001890. doi: 10.1136/bmjophth-2024-001890.
To assess the impact of eye drops containing high molecular weight hyaluronic acid (HMW-HA) and low molecular weight hyaluronic acid (LMW-HA) on corneal nerve regeneration, dendritic cell (DC) density, corneal sensitivity (CS) and ocular surface parameters in patients with keratoconus following corneal crosslinking (CXL).
63 eyes of 55 patients with keratoconus were randomised to receive eye drops containing HMW-HA (n: 20) for 12 months, LMW-HA (n: 23) for 12 months and polyvinyl alcohol (n: 20) until closure of the epithelial defect in the control group after CXL. Subbasal nerve plexus (SNP) was imaged with corneal confocal microscopy and quantified with ACCMetrics. DC density was calculated with Image J. Ocular Surface Disease Index (OSDI) questionnaire and non-invasive break-up time (NI-TBUT) were evaluated. All measurements were performed before CXL and 1, 3, 6 and 12 months postsurgery.
At 6 months post-CXL, SNP reached to its preoperative. CS was higher in the HMW-HA groups compared with the other two groups in the 3rd and 6th month post-CXL. DC density was higher in the LMW-HA group compared with the HMW-HA group in the postoperative 3rd month. OSDI were higher in the control group compared with both the LMW-HA and HMW-HA groups at postoperative 3rd and 6th months. NI-TBUT was lower in the control group in the 6th and 12th months compared with the other groups.
The use of artificial tear drops containing HMW-HA may have a therapeutic effect to promote corneal nerve regrowth and support faster functional recovery after CXL.
NCT06243991.
评估含高分子量透明质酸（HMW-HA）和低分子量透明质酸（LMW-HA）的滴眼液对圆锥角膜患者角膜交联术（CXL）后角膜神经再生、树突状细胞（DC）密度、角膜敏感性（CS）和眼表参数的影响。
将55例圆锥角膜患者的63只眼随机分为三组，分别接受含HMW-HA的滴眼液治疗12个月（n = 20）、含LMW-HA的滴眼液治疗12个月（n = 23），以及在CXL术后对照组使用聚乙烯醇滴眼液直至上皮缺损闭合（n = 20）。使用角膜共聚焦显微镜对基底膜下神经丛（SNP）进行成像，并通过ACCMetrics进行量化。使用Image J计算DC密度。评估眼表疾病指数（OSDI）问卷和非侵入性泪膜破裂时间（NI-TBUT）。所有测量均在CXL术前以及术后1、3、6和12个月进行。
CXL术后6个月，SNP恢复至术前水平。在CXL术后第3个月和第6个月，HMW-HA组的CS高于其他两组。术后第3个月，LMW-HA组的DC密度高于HMW-HA组。在术后第3个月和第6个月，对照组的OSDI高于LMW-HA组和HMW-HA组。在第6个月和第12个月，对照组的NI-TBUT低于其他组。
使用含HMW-HA的人工泪液滴眼液可能具有促进角膜神经再生的治疗作用，并有助于CXL术后更快的功能恢复。
NCT06243991。
