Treatment of corneal chemical alkali burns with a crosslinked thiolated hyaluronic acid film

Burns. 2018 Aug;44(5):1179-1186. doi: 10.1016/j.burns.2018.01.016. Epub 2018 Feb 9.

Abstract

Purpose: The study objective was to test the utilization of a crosslinked, thiolated hyaluronic acid (CMHA-S) film for treating corneal chemical burns.

Methods: Burns 5.5mm in diameter were created on 10 anesthetized, male New Zealand white rabbits by placing a 1N NaOH soaked circular filter paper onto the cornea for 30s. Wounds were immediately rinsed with balanced salt solution (BSS). CMHA-S films were placed in the left inferior fornix of five injured and five uninjured animals. Five animals received no treatment. At 0h, 48h, 96h, and on day 14 post chemical burn creation, eyes were evaluated by white light imaging, fluorescein staining, and optical coherence tomography (OCT). Corneal histology was performed using H&E and Masson's Trichrome stains.

Results: Image analysis indicated biocompatible CMHA-S treatment resulted in significant decreases in the areas of corneal opacity at 48h, 96h, and on day 14 postoperatively. A significant increase in re-epithelialization was seen 14days post injury. CMHA-S treated corneas showed significantly less edema than untreated burns. No pathological differences were observed in corneal histological samples as a result of CMHA-S treatment.

Conclusions: CMHA-S films facilitate re-epithelialization and decrease the area of corneal opacity in our corneal alkali burn rabbit model.

Keywords: Corneal wound healing; Epithelium; Hyaluronic acid; Polymer.

MeSH terms

  • Alkalies / toxicity
  • Animals
  • Burns, Chemical / drug therapy*
  • Caustics / toxicity
  • Cornea / diagnostic imaging
  • Cornea / drug effects*
  • Cornea / pathology
  • Corneal Edema
  • Corneal Injuries / chemically induced
  • Corneal Injuries / drug therapy*
  • Corneal Opacity
  • Disease Models, Animal
  • Epithelium, Corneal / drug effects
  • Eye Burns / chemically induced
  • Eye Burns / drug therapy*
  • Hyaluronic Acid / pharmacology*
  • Intravital Microscopy
  • Male
  • Microscopy, Confocal
  • Rabbits
  • Re-Epithelialization / drug effects*
  • Sodium Hydroxide / toxicity
  • Sulfhydryl Compounds / pharmacology*
  • Tomography, Optical Coherence
  • Viscosupplements / pharmacology*

Substances

  • Alkalies
  • Caustics
  • Sulfhydryl Compounds
  • Viscosupplements
  • Sodium Hydroxide
  • Hyaluronic Acid