Effect of 2% Hyaluronic Acid on the Rate of Healing of Corneal Epithelial Defect After Pterygium Surgery: A Randomized Controlled Trial

Drug Des Devel Ther. 2021 Oct 27:15:4435-4443. doi: 10.2147/DDDT.S336372. eCollection 2021.

Abstract

Purpose: The study aimed to investigate the effects of 2% hyaluronic acid (HA) on corneal epithelial defect after pterygium surgery in comparison with the control group, measured in terms of the healing rate of corneal epithelial defect and pain score after surgery.

Methods: In this double-blind randomized clinical trial, fifty patients with primary pterygium were randomized into 2 groups: a control group or the group treated with a single topical application of 2% HA. Comprehensive ophthalmological examinations included measuring the area of corneal epithelium defect using ImageJ freeware and the pain score assessment after the operation.

Results: The mean and SD of the area of epithelial defect measured on postoperative Day 0, 1, and 2 were 10.89 ± 1.33 mm2, 5.04 ± 0.87mm2, and 2.44 ± 0.74 mm2 for the HA group, and 11.14 ± 1.11 mm2, 7.74 ± 1.17 mm2, and 5.31 ± 1.15 mm2 for the control group, respectively. While the initial area of the defect on Day 0 was essentially the same for both groups (p = 0.478), the area of the defect in the HA group was significantly smaller on both Day 1 and Day 2 (p < 0.001, p < 0.001), respectively. Similarly, the HA group exhibited a statistically significant higher rate of healing for the cornea epithelial defect over Day 0 and 1 compared to the control group (5.85 ± 0.89 mm2/day vs 3.14 ± 1.28 mm2/day, p < 0.001), respectively. The median (range) pain scores were evaluated at Day 0 was 7 (4-10) in the HA group and 7 (3-10) in the control group (p = 0.953). There was no statistically significant difference between two groups (p > 0.05) for Days 1, 2, and 3.

Conclusion: A single topical application of 2% HA tended to accelerate the healing process of corneal epithelium defect after pterygium surgery without any observable adverse effects during short-term follow-up.

Keywords: 2% hyaluronic acid; corneal epithelial defect; pterygium surgery.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Administration, Topical
  • Adult
  • Double-Blind Method
  • Epithelium, Corneal / drug effects*
  • Epithelium, Corneal / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Hyaluronic Acid / administration & dosage*
  • Hyaluronic Acid / adverse effects
  • Male
  • Middle Aged
  • Pain Measurement
  • Pain, Postoperative / epidemiology
  • Postoperative Period
  • Prospective Studies
  • Pterygium / surgery*
  • Time Factors
  • Wound Healing / drug effects*

Substances

  • Hyaluronic Acid

Grants and funding

This study was supported by the Faculty of Medicine Endowment Fund, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand (Grant Number 014/2561).