Abstract
Purpose: :
To assess the efficacies of three approved artificial tears in the management of lipid deficient dry eye.
Methods: :
Seventy-five subjects with mild to moderate dry eye were enrolled. The subjects were allocated either Lubristil® (sodium hyaluronate); Dacriosol® (HPMC); or Emustil® (oil-in-water emulsion) eye drop 4 times daily for 90 days. Tear parameters including evaporimetry, interferometry, osmolarity and tear turn over rate were measured at baseline and at 30 and 90 days.
Results: :
Significant reductions in evaporation with all solutions were found. The oil-in-water emulsion reduced evaporation significantly more than the sodium hyaluronate and HPMC. There was a significant difference in tear stability pre and post therapy with emulsion and sodium hyaluronate, but not with the HPMC. No statistically significant increase in tear turnover was found with any therapy. No significant difference in osmolarity was found with either the sodium hyaluronate or the HPMC. The mean decrease in osmolarity was significantly greater with the emulsion than the sodium hyaluronate and the HPMC. A significant improvement in symptoms for all drops was found from baseline to 90 days. There was a significant improvement in corneal staining at 90 days post therapy with the emulsion, but not with either the sodium hyaluronate or HPMC. Improvements in tear break up time were found at 60 days post therapy with the emulsion and sodium hyaluronate drops but not with the HPMC.
Conclusions: :
The emulsion eye-drops significantly reduced the evaporative rate, improved film stability, and decreased osmolarity of the tear film and improved corneal staining and non-invasive tear break up time. The improvements found with the emulsion were greater than those for hyaluronate or HPMC based drops.
Keywords: cornea: tears/tear film/dry eye