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Yosai Mori, Ryohei Nejima, Ayami Masuda, Yoko Maruyama, Keiichiro Minami, Kazunori Miyata; Efficacy of rebamipide for laser in situ keratomileusis-associated dry eye. Invest. Ophthalmol. Vis. Sci. 2013;54(15):945.
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© ARVO (1962-2015); The Authors (2016-present)
Dry eye syndrome is a major complication after laser in situ keratomileusis (LASIK), and is occasionally hard to improve with an artificial tear or hyaluronic acid treatment. Rebamipide is a quinolinone derivative stimulating mucin secretion as well as increasing goblet cells on the conjunctiva, resulting in improvement of ocular surface disorders. Aim of the study is to evaluate the efficacy of rebamipide for dry eye after LASIK.
This prospective study comprised 32 eyes of 16 patients who had LASIK-associated dry eye and had been treated with the artificial tear or hyaluronic acid eye drop. Rebamipide 2% eyedrop (Mucosta, Ohtsuka Pharmaceutical) was additionally instilled 4 times a day for 4 weeks. Tear secretin was examined with the Schirmer test with anesthesia before and at 4 weeks after the rebamipide treatment. Tear breakup time (BUT), fluorescein stain, and lissamine green stain were examined before and at 1 and 4 weeks. Fluorescein staining on the cornea was evaluated by the summation of area and density scores (none:0 to severe:3). Lissamine green staining in the conjunctiva was scored in none:0 to full:18. Questionnaire of 14 symptoms according to Ocular Surface Disease Index was performed before and at 4 weeks. Change in the examinations after the additional treatment was evaluated with the Friedman's test following Scheffe ad-hoc comparison. Symptoms were compared with the Wilcoxon signed-ranks test.
Mean tear secretin did not change beween before rebamipide treatment (8.8 mm) and after 4 weeks (8.2 mm). BUT significantly increased from before (3.4 sec.) to 1 week (4.8 sec., P<0.001), and continued up to 4 weeks (5.0 sec.). Fluorescein and lissamine green staining scores were also improved from 1 week after the rebamipide treatment (P<0.001). There were significant improvement in 9 symptoms (fatigue, dryness, grittiness, heavy eyelids, pain, discomfort, blurred vision, light sensitivity, dry place).
Addition of rebamipide 2% improved ocular surface disorder and dry eye symptoms. It was demonstrated that mucin secretion in the tear film due to the rebamipide effectively improved LASIK-associated dry eye.
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