4 · Mechanical, surgical adjuncts & fibrosis modulators
Hyperbaric oxygen therapy (HBOT)
Review — modulators of corneal healing › 4 · Mechanical, surgical adjuncts & fibrosis modulators › Hyperbaric oxygen therapy (HBOT)
Hyperbaric oxygen therapy (HBOT)
100% O₂ at 2–2.5 ATA · niche adjunct
Oxford IV–V (clin.) · II (exp.)
Weak / Investigational
Present · niche
Mechanism of action↑Tissue O₂ pressure → supports epithelial mitochondrial/ATP metabolism (migration/proliferation), limbal neovascularization in cases of ischemia, anti-edema/antimicrobial effect. Animal data: accelerated healing (acetylcholine pathway).
IndicationsRefractory/ischemic ulcers, chemical burns with limbal ischemia, anterior segment ischemia, post-embolic keratitis (adjunct, not routine).
Route & dosageHBOT sessions ~90 min at 2–2.5 ATA, daily, multiple sessions; or localized O₂ (experimental).
Level of evidenceOxford IV–V clinical · Scale: Weak / Investigational (cornea).
| FDA / EU MA | HBOT approved for defined indications (not specifically corneal); ocular use is off-label/adjunctive. |
|---|---|
| France / USA / Asia | Available at hyperbaric centers. |
Key studies: oxygen supply and epithelial healing (acetylcholine) — PMID 34845423 ; HBOT in ophthalmology (J Clin Med 2024) — PMID 38202036.