KietPhang Ling1, Mae-Lynn Catherine Bastion2. 1. Ophthalmology Department, Sultanah Aminah Hospital, Johor Bahru, Malaysia. lingkietphang@hotmail.com. 2. Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
Abstract
PURPOSE: To evaluate the effect of topical sodium hyaluronate (SH) 0.18% treatment on corneal epithelial healingafter epithelial debridement in parsplana vitrectomy in diabetic patients. METHOD: This is prospective and randomized clinical trial. Our study population included 30 eyes undergoingpars plana vitrectomy that required near total corneal debridement intra-operatively for surgical view. We compared the residual wound and wound healing rate in between 3 groups: 10 diabetic eyes (DMV) on topical SH 0.18%; 10 diabetic eyes (DMC) and 10 non-diabetic eyes (NDM) not treated withtopical SH 0.18%. The corneal epithelial wound was measured at 12, 24, 36, 48, 60, 72 and 120 h after the vitrectomy surgery. RESULTS:DMC group had corneal wounds that reepithelialization significantly more slowly than in NDM and DMV groups at 12, 24, 36 and 48 h (Mann-Whitney test p < 0.05). The epithelial healing rate was significantly faster at 12 h in NDM and DMV group (Mann-Whitney test p < 0.05). No differences in the residual epithelial wound and wound healing were detected in between NDM and DMV groups. The mean for epithelial closure in DMC group was delayed 87.6 ± 28.31 h, compared with DMV group (64.8 ± 21.31) and NDM group (56.4 ± 9.88). All groups were followed up 1 month beyond completed wound closure. No recurrent corneal epithelial wound, corneal melting or corneal neovascularization was noted. CONCLUSION:Diabetic patients on SH 0.18% four times daily for epithelial defect had similar corneal wounds healing rate as non-diabetics. This treatment significantly improved corneal wound healing and accelerated complete corneal wound resurfacing in diabetic patients.
RCT Entities:
PURPOSE: To evaluate the effect of topical sodium hyaluronate (SH) 0.18% treatment on corneal epithelial healing after epithelial debridement in pars plana vitrectomy in diabeticpatients. METHOD: This is prospective and randomized clinical trial. Our study population included 30 eyes undergoing pars plana vitrectomy that required near total corneal debridement intra-operatively for surgical view. We compared the residual wound and wound healing rate in between 3 groups: 10 diabetic eyes (DMV) on topical SH 0.18%; 10 diabetic eyes (DMC) and 10 non-diabetic eyes (NDM) not treated with topical SH 0.18%. The corneal epithelial wound was measured at 12, 24, 36, 48, 60, 72 and 120 h after the vitrectomy surgery. RESULTS:DMC group had corneal wounds that reepithelialization significantly more slowly than in NDM and DMV groups at 12, 24, 36 and 48 h (Mann-Whitney test p < 0.05). The epithelial healing rate was significantly faster at 12 h in NDM and DMV group (Mann-Whitney test p < 0.05). No differences in the residual epithelial wound and wound healing were detected in between NDM and DMV groups. The mean for epithelial closure in DMC group was delayed 87.6 ± 28.31 h, compared with DMV group (64.8 ± 21.31) and NDM group (56.4 ± 9.88). All groups were followed up 1 month beyond completed wound closure. No recurrent corneal epithelial wound, corneal melting or corneal neovascularization was noted. CONCLUSION:Diabeticpatients on SH 0.18% four times daily for epithelial defect had similar corneal wounds healing rate as non-diabetics. This treatment significantly improved corneal wound healing and accelerated complete corneal wound resurfacing in diabeticpatients.