A controlled experimental study published in Cornea (2014) investigated the effects of high-concentration hyaluronic acid (HA 2.3%) compared with chloramphenicol eye drops, chloramphenicol ointment, and no treatment on the healing of superficial corneal epithelial defects.
The study used 23 rabbit eyes, where standardized 6 mm corneal erosions were created. Animals were randomly assigned to four groups and treated every 8 hours until complete re-epithelialization. Healing progression was monitored using fluorescein staining and serial imaging to measure reduction of the epithelial defect over time.
The study found that there were no significant differences in healing time between treated groups.
- Corneal erosions healed in approximately 72–75 hours in the chloramphenicol and hyaluronic acid treatment groups
- The untreated control group healed faster, with an average healing time of about 51 hours
- Statistical analysis confirmed that neither HA 2.3% nor chloramphenicol accelerated epithelial healing in this model
The authors concluded that neither topical antibiotics nor high-concentration hyaluronic acid improved the healing rate of uncomplicated superficial corneal erosions in this experimental setting. In fact, both treatments showed a tendency toward slightly slower healing compared to no intervention.
The study highlights an important clinical principle: in simple corneal epithelial injuries without infection, supportive topical treatment does not always enhance the natural healing process. Management decisions should therefore focus on infection prevention, patient comfort, and clinical severity rather than expecting faster epithelial closure.
Although this study evaluated standard non–cross-linked hyaluronic acid, it provides useful context for modern ophthalmic formulations. Cross-linked hyaluronic acid technologies, such as those used in BioHAnce™, are designed to improve:
- Retention time on the ocular surface
- Tear film stability
- Mechanical protection of damaged epithelium
This distinction is important, as formulation technology rather than concentration alone may determine clinical performance in corneal healing support.
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