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Charles Connor, Raelyn Ottenbreit, Laura Schroeder, Jeff Rabin, Srihari Narayanan; Comparison of Three Commercially Available Tear Substitutes Designed for Evaporative Dry Eye Treatment. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4322.
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© ARVO (1962-2015); The Authors (2016-present)
Topical rewetting agents still constitute the basis of dry eye therapy. A high prevalence of evaporative dry eyes has generated the need for a lipid component in rewetting agents. Our study compares the short term effect of 3 commercially available rewetting agents designed for evaporative dry eye patients based on Non-invasive tear breakup time (NITBUT) and contrast sensitivity.
Twenty four subjects (14 female, 10 male, ave. age 25.33+/-2.8 yrs) were divided into two groups based on the Effron scale for Meibomian gland dysfunction (MGD). A score of 1+ or greater was used for inclusion in the MGD group (14 subjects). Based on OSDI score the MGD subjects were in the mild symptom range.The other 10 subjects served as control. Baseline measures of VA, contrast sensitivity, OSDI and NITBUT were performed on all subjects. Then, one drop of each of the 3 agents tested was instilled. The agents tested were Allergan Optive, Alcon Systane Balance and Ocusoft Retaine. NITBUT was determined at 1.5,10,30,45 and 60 minutes after instillation. Contrast was remeasured right after instillation. The 3 agents were tested on all subjects in 3 separate visits.
A 2-way repeated measures ANOVA failed to reveal significant differences in V.A or C.S between the two groups. But there was a slight improvement (25%) in contrast after drop instillation for all agents tested.Mean NITBUT for the MGD group at baseline with Allergan Optive was 8.4, 13.5 , 9.3 , 9.1 , 8.4 and 7.7 sec (at the time points mentioned above in order) while the control NITBUT were 9.1,10.5,9.2,9.1,8.5 and 7.7sec. The results for Alcon Systane Balance were:7.7,10.7,10.6, 9.2, 8.7 and 8.4 for the MGD group while the control NITBUT were: 9.4,10.4,9.2,9.0,11.1 and 7.9. The results for Ocusoft Retaine were: 7.6, 9.9, 8.6, 9.5, 8.0 and 8.4 for the MGD group while the control NITBUT were: 6.1,7.8, 6.2, 7.4, 8.6 and 5.4 sec. Subjects preferred Optive (83%) in terms of drop comfort, followed by Balance (62.5%) and Retaine (58%). The largest initial effect on the NITBUT was 5.1 seconds improvement with Optive 90 seconds after instillation.
Our data suggests that all 3 agents had effects that persisted for at least 45 minutes before a return to baseline NITBUT. Overall the NITBUT data suggests that any of these products would be a reasonable choice for mild evaporative dry eye comfort in the 1 hour range.
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