Abstract:AIM: To analyze the healing effect of a new hyaluronic acid (HA) photo-crosslinked ocular adhesive for corneal and conjunctival wounds and evaluate its clinical potential in ocular surface reconstruction. METHODS: Male New Zealand rabbits were included. A full-thickness corneal wound was induced in the superior corneal limbus, and a 5×5 mm2 conjunctival flap was dissected while leaving intact the lateral limbus of the cornea. The rabbits were randomly divided into corneal and conjunctival wound groups, each containing three subgroups. Histological findings and transmission electron microscopy (TEM) were used to compare wound healing parameters of inflammation and collagen remodeling at 7 and 14d post-injury. RESULTS: Thirty rabbits (14–16 weeks old, 3.0±0.5 kg) were included and were randomly assigned to either a corneal injury group (n=15) or a conjunctival injury group (n=15). Each group was further divided into three subgroups: control, enbucrilate, and HA photo-crosslinked adhesive (HPCA) groups (n=5 each). Anterior chamber leakage was observed until the first day in the control group, whereas corneal wound recovery was observed in the other two adhesive groups. Rabbits in the enbucrilate group exhibited significantly higher numbers of infiltrating inflammatory cells compared to HPCA group at both days 7 and 14 post-injury, along with irregular collagen fiber rearrangement. The HPCA group had fewer infiltrating inflammatory cells in the corneal wound area compared to the control (P=0.043, 0.033 on days 7 and 14 post-injury, respectively) and enbucrilate groups (P=0.004, 0.017 on days 7 and 14 post-injury, respectively). It displayed significantly fewer infiltrating inflammatory cells in conjunctival tissue wounds than the other two groups (P=0.043 and 0.033 on day 7 post-injury, both P<0.001 on day 14 post-injury). The regenerated conjunctival tissue in the HPCA group displayed a uniform collagen arrangement, indicating smoother, regular wound healing. CONCLUSION: The HPCA causes less inflammatory infiltration and more uniform collagen fiber arrangement during corneal and conjunctival tissue wound healing than control and enbucrilate groups, indicating its usefulness for ocular surface reconstruction.
