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C. G. Connor; Evaporative Dry Eye Treated With Transdermal Testosterone. Invest. Ophthalmol. Vis. Sci. 2008;49(13):120. doi: https://doi.org/.
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Previously we demonstrated that transdermal testosterone relieved symptoms of aqueous deficient dry eye but was less successful in treating evaporative dry eye. The present study is focused on treatment of evaporative dry eye. In an attempt to improve efficacy of this treatment we increased the concentration of testosterone from 3 to 5% and changed the application technique.
Twenty one females with evaporative dry eye having an average age of 47.47yrs with an age range of 22 to 68 yrs were enrolled in this study. Evaporative dry eye was defined as a reduced TBUT with a normal Schirmer test. Rather than using digital application to the eyelids, the patients were asked to apply the 5% testosterone cream like they would apply eyeliner using a cotton tip applicator. We thought this would enhance drug delivery to the meibomian glands which are most affected by evaporative dry eye. Baseline data collected was TBUT, Schirmer, and OSDI questionnaire. After applying the testosterone cream to the eyelid margins twice a day for 3 weeks the same tests were repeated. Statistical significance was determined by a two tail t-test.
Baseline TBUT was 3.41 +/- 1.87 seconds and increased after cream use to 8.355 +/- 3.30 and this difference was statistically significant at the p=0.05 level. The Schirmer test results showed a small increase but it was not statistically significant (13.4 +/-7.8 to 15 +/- 7.7). The OSDI score reflected symptomatic improvement of 59% going from 42.87 to 26.93.
Transdermal delivery of testosterone to the eyelid margins appears to be a safe and effective treatment for evaporative dry eye. The eyelid margin application technique with increased testosterone concentration improved patient comfort and tear breakup time.
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