potential therapy of asiatic acid to prevent scar remodeling post-strabismus surgery

Strabismus, also known as ocular misalignment or crossed eyes, refers to an abnormality characterized by a deviation in the alignment of the eyeballs. following strabismus surgery, there is a possibility of postoperative inflammation leading to the development of fibrotic tissue. inflammation elicits a cellular response characterized by the presence of neutrophil cells, subsequently accompanied by the emergence of pro-inflammatory cytokines, such as tnf-α. the occurrence of conjunctival scar is a prevalent local consequence observed in around 90% of strabismus procedures that involve the manipulation of more than one muscle. dexamethasone is a synthetic adrenal corticosteroid with potent anti-inflammatory effects, mostly inhibiting undesired immune system reactions. the subconjunctival administration of dexamethasone is commonly employed during strabismus surgery to mitigate inflammation. subconjunctival steroid injection near the affected cornea or sclera can weaken the tissue, which may result in rupture at the injection site. centella asiatica, commonly referred to as gotu kola leaves in indonesia, is recognized as a potent botanical agent employed in traditional medicine. asiatic acid, the primary component of centella asiatica saponins, exhibits a diverse range of biological actions, including anti-inflammatory, anti-fibrotic, antioxidant, and neuroprotective effects. the administration of asiatic acid has been found to exhibit an anti-fibrotic action through the inhibition of tgf-𝛽 signaling. in addition, it can decrease the infiltration of inflammatory cells in bronchoalveolar lavage fluid (balf) and the production of pro-inflammatory cytokines.