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YOSAI MORI, RYOHEI NEJIMA, AYAMI MASUDA, YOKO MARUYAMA, KEIICHIRO MINAMI, KAZUNORI MIYATA; Efficacy Of Diquafosol Tetrasodium For Chronic Dry Eye After Laser In Situ Keratomileusis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):574.
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Chronic dry eye is one of major complications after laser in situ keratomileusis (LASIK) and is hard to improve with artificial tear or hyaluronic acid treatment. Diquafosol tetrasodium is P2Y2 receptor agonist stimulating tear fluid and mucin secretion, and would improve ocular surface disorders in dry eye. Aim of the study is to evaluate the efficacy of diquafosol tetrasodium for chronic dry eye after LASIK.
This prospective study comprised 30 eyes of 15 patients who had dry eye over 12 months after LASIK with artificial tear or hyaluronic acid treatment. Diquafosol tetrasodium 3% eyedrop was additionally instilled 6 times a day for 12 weeks. Tear secretin was examined with the Schirmer test before and at 4 and 12 weeks after diquafosol treatment. Tear breakup time (BUT), fluorescein stain, and lissamine green stain were examined before and at 1, 4 and 12 weeks. In fluorescein staining on the cornea, area and density were scored in 0 to 3 and the summation was evaluated. Lissamine green staining in the conjunctiva was scored in 0 to 18. Questionnaire of 14 symptoms according to Ocular Surface Disease Index was performed before and at 12 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 diquafosol treatment (7.4 mm) and after 4, 12 weeks (7.5, 7.2 mm). BUT significantly increased from before (3.1 sec.) to 1 week (4.6 sec., P<0.001), and continued up to 12 weeks (5.1 sec.). Fluorescein and lissamine green staining scores were also improved from 1 week after the diquafosol treatment (P<0.001). There were significant improvement in 6 symptoms (fatigue, dryness, discomfort, grittiness, reading, dry place).
Additional instillation of diquafosol tetrasodium 3% improved ocular surface disorder and dry eye symptoms. It was demonstrated that diquafosol tetrasodium facilitated tear fluid and mucin secretion and effectively improved chronic dry eye after LASIK.
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