A comparative evaluation of the efficacy of hyaluronic acid drops containing trehalose, dexpanthenol, Coenzymeq10 and vitamin E in ocular surface epithelial defect model induced by experimental chemical burn in rabbit eyes

Ocular chemical burn is a serious ocular emergency requiring urgent evaluation and care. The presence of an epithelial defect in ocular chemical burn is one of the most important factors in determining the treatment response. Tear solutions containing different active ingredients are used to treat the corneal surface. Artificial tears are the mainstay of ocular chemical injury treatment and are routinely used to promote epithelialization. The aim of this study is to compare the effects of preservative-free eye drops containing trehalose +HA (hyaluronic acid)(Group T); dexpanthenol+HA (Group P), coenzyme q10+Vitamin E+HA (Group V) active ingredients on ocular chemical burn corneal healing with the control group and each other. In our study, experimental chemical burns were induced in the right eyes of 22 New Zealand breed rabbits and randomized into 4 groups as Group T, Group P, Group V and control group. Each treatment group was consisted of 6 rabbits and the control group was consisted of 4 rabbits. In one month follow-up period the epitelial defect findings in the anterior segment and clinical findings as chemosis, conjuctival hyperemia and eyelid edema were recorded. Corneas were prepared for histologic, immunohistochemical and electron microscopic evaluation. After one month follow-up, the rabbits were sacrificed. The epithelial defect areas and clinical findings were statistically evaluated. There was no difference between the groups in terms of epithelial defect area sizes on days 1, 3 and 5. On the other hand, epithelial defect healing from day 1 to day 3, from day 3 to day 5 and from day 1 to day 5 in the treatment group was significant whereas the epithelial defect healing in the control group was not significant. There was no significant difference between the clinical findings between the groups. In histological examination, we obtained the best healing in terms of stromal edema, epithelial deterioration and lymphatic infiltration in group P.The rate of alpha sma (alpha smooth actin) positive areas was higher in group P and V, but this difference was not found to be statistically significant. In electron microscopic examination, higher improvement in anterior surface epithelial formation and collagen arrangement was noted in the treatment groups compaired to the control group. In our study, epithelial defect healing rate was better in all three treatment groups compaired to the control group. This finding was consistent with other studies in the literature that showed the superiority of trehalose, dexpanthenol and coenzyme q10 over the control group. Morever, the histologic and immunohistochemical evaluations showed better healing signs in groups P and V than group T. We believe that our study is the first study in the literature comparing artificial tears with trehalose, dexpanthenol, coenzyme q10 active ingredients with each other in terms of epithelial defect healing.