Introduction: The ocular surface is a complex functional unit whose normal functions are regulated by the nervous system, particularly expressed at the corneal level. Various diseases, and also traumatic injuries, can lead to the alteration of the ocular surface. In case of trauma, the main purpose of ocular surface therapy is to repair the epithelial damage. A gel formulation based on trehalose/ sodium hyaluronate/carbomer may represent a valid strategy to help the epithelial repair processes, thanks to its protective and repairing action.
Aim: To evaluate the effect of a gel formulation based on trehalose/ sodium hyaluronate/carbomer without eye patching compared to topical antibiotic therapy with eye patching, in recovering epithelial damage caused by mechanical injury.
Materials and methods: An observational study involving 262 patients referred to the Ophthalmology Clinic in Rome between May 2014 and June 2017 for corneal and/or cornealconjunctival lesion caused by a foreign body or by traumatic corneal abrasion. Ethical approval was obtained , and only consenting subjects were involved. The first group involved 158 patients who underwent corneal foreign body removal and were treated for 7 days as follows: 83 patients received a gel formulation based on trehalose/sodium hyaluronate/carbomer four times a day, without occlusive eye patch; 75 patients were treated with topical antibiotic therapy four times a day and occlusive eye patch. The second group included 104 patients with corneal abrasion who underwent the same treatments described for the first group of patients (50 vs 54 patients, respectively).
Results: After 4 days of treatment, the recovery rate was significantly higher in both groups of patients treated with the gel formulation based on trehalose/sodium hyaluronate/ carbomer, compared to patients treated with topical antibiotic therapy (73% vs 32%, p<0.01; Group 1) (78% vs 29%, p<0.01; Group 2). The difference was maintained even after 7 days of treatment (98% vs 91%, p<0.01; Group 1) (100% vs 87%, p<0.01; Group 2). A statistically significant difference was found after 4 days of treatment in subjective parameters such as pain (0.22 vs 0.47, p<0.01; Group 1) (0.1 vs 0.5, p<0.01; Group 2), burning sensation (0.23 vs 0.79, p<0.01; Group 1) (0.1 vs 0.8, p<0.01; Group 2) and foreign body sensation (0.51 vs 1.37, p<0.01; Group 1) (0.4 vs 1.8, p<0.01; Group 2).
Conclusions: Treatment with a gel formulation based on trehalose/ sodium hyaluronate/carbomer without occlusive patch seems a valid alternative to the application of an antibiotic ophthalmic ointment and occlusive eye patching.