A dual-drug chitosan–hyaluronic acid bandage contact lens accelerates corneal re-epithelialization in a rabbit mechanical debridement model

Abstract

Abstract Rapid corneal re-epithelialization is crucial to prevent infection and scarring, yet the efficacy of conventional topical therapies is hindered by their limited ocular bioavailability. To address this, we developed a daily replaceable chitosan–hyaluronic acid (CS–HA) bandage contact lens co-loaded with levofloxacin and betamethasone using a soaking-based drug-loading approach. In a rabbit 8-mm mechanical corneal debridement model ( n  = 15/group), the dual-drug CS–HA lens was compared with a chitosan-only drug-loaded lens, a commercial silicone-hydrogel bandage lens plus drops, and drops alone. The CS–HA lens maintained adequate optical transparency, water content, and oxygen permeability suitable for short-term wear. In vitro assays showed that the dual-drug CS–HA lens retained antibacterial inhibitory activity in agar diffusion tests and reduced TNF-α secretion in an LPS-stimulated THP-1 assay. Re-epithelialization was significantly faster with the CS–HA lens, achieving complete closure at a median of 3 days versus 5, 6, and 8 days in the respective control groups. Day-10 histology showed a well-stratified epithelium with no evidence of stromal inflammatory infiltration in the CS–HA group, whereas controls exhibited greater stromal disorganization. This biocompatible dual-drug platform may accelerate ocular surface restoration and reduce reliance on frequent topical dosing in settings such as post-refractive surgery care and persistent epithelial defects.