Dexpanthenol/sodium hyaluronate eye drops for corneal epithelial healing following corneal cross-linking in patients with keratoconus.

Abstract

To evaluate the effect of dexpanthenol 2%/sodium hyaluronate 0.15% eye drops on corneal epithelial healing and corneal microstructural changes following corneal cross-linking (CXL) in patients with keratoconus. The study included 42 eyes of 21 patients with keratoconus who underwent CXL on both eyes. One eye of each patient was instilled dexpanthenol 2%/sodium hyaluronate 0.15% eye drops (DP/SH group) and the fellow eye was instilled unpreserved sodium hyaluronate 0.15% eye drops (SH group). The epithelial healing process was assessed every day until complete reepithelialization was achieved. The in vivo confocal microscopy (IVCM) findings were also recorded. The mean epithelial defect size 48.6 ± 6.7 mm2 for the DP/SH group and 48.2 ± 5.3 mm2 for the SH group. Complete reepithelialization was seen after 2.24 ± 0.44days (range 2-4days) in the DP/SH group and 3.43 ± 0.60days (3 to 5days) in the SH group. Posterior keratocyte density and endothelial cell density were similar in both groups. The mean subbasal nerve plexus density was significantly higher in the DP/SH group (postoperative 1month: 1.13 ± 1.51, 3months: 3.53 ± 2.55, 6months: 7.07 ± 1.42) compared to the SH group (postoperative 1month: 0.87 ± 1.43, 3months: 2.89 ± 2.62, 6months 6.33 ± 1.29). The DP/SH group revealed faster subbasal nerve regeneration and less edema compared to the SH group. Dexpanthenol 2%/sodium hyaluronate 0.15% eye drops were effective and safe for corneal epithelial healing, and promoted faster corneal reepithelialization, nerve regeneration, and keratocyte repopulation with reduced corneal edema compared to sodium hyaluronate eye drops.