PURPOSE: Hyaluronic acid is used for the treatment of dry eye. In this study we evaluated the effects of hyaluronic acid on epithelial wound healing in cases of moderate and severe dry eye.
METHODS: We examined 112 eyes of 56 dry eye patients (average age 44 years, 44 females, 12 males). After an initial examination of the ocular surface the patients applied hyaluronic acid four times a day. Slit lamp examination followed on the first, third, fifth and seventh day of hyaluronic acid application. Epithelial lesions were stained with Lissamine green. A scoring of the epithelial lesions was done according to the Rose Bengal Scoring of Bijsterfeld.
RESULTS: The average Lissamine green score for all eyes (n=112) was 3.0 and 5.3 for the severe dry eye cases (n=38). On the fifth day of Lissamine green application the mean score was 1.5 for all eyes and 2.1 for severe dry eyes. The differences were statistical significant (p < 0.001). All contact lens wearers (n=21) reported an improved contact lens tolerance.
CONCLUSIONS: The use of hyaluronic acid is an effective and save method of treating dry eye. Especially severe cases of dry eye showed a significant reduced count of epithelial lesions. Hyaluronic acid is known to interact with CD44 receptors of epithelial cells and to promote the wound healing by stimulation of cell migration, proliferation and differentiation.
ADDITIONAL COMMENTS: We would like to thank Raphael Eschmann FAAO for supporting this study.