Purpose:
To determine the efficacy of acupuncture in the treatment of moderate to severe dry eye.
Methods:
In this randomized, prospective, double–blinded, placebo–controlled treatment trial, patients with dry eyes with persistent signs and symptoms despite conventional therapy were randomized into one of two study groups: sham acupuncture treatment vs. acupuncture treatment. Patients and investigators performing the eye exams were blinded to treatment group. McMonnies dry eye questionnaire, visual acuity, manifest refraction, slit–lamp examination, corneal topography, corneal sensation, Schirmer's test with and without anesthesia, fluorescein tear break–up time (TBUT), and conjunctival and corneal staining with Rose Bengal (RB) were assessed at baseline and at 1 day, 1 week, and 1 month post–treatment. Within subject (e.g., comparison of before and after treatment) and between subject (e.g., acupuncture vs. sham) comparisons were analyzed using the independent t–test .
Results:
Twelve patients enrolled in the study: 6 treated with acupuncture and 6 with sham treatment. There was significant improvement in McMonnies questionnaire score, TBUT, and RB score in the acupuncture group when compared to the sham treatment group at 1 month. (Table 1) While Schirmer’s test with and without anesthesia both improved in the acupuncture group, this difference was not statistically significant. There were no complications with acupuncture treatment.
Conclusions:
Acupuncture has been reported as an effective treatment for dry mouth, presumably due to parasympathetic activation. In this small pilot study, acupuncture resulted in improvement in self–reported dry eye symptoms and 2 of 4 objective measures of dry eye compared to sham treatment. Acupuncture may be a valuable adjunct therapy for refractory dry eyes. Change from baseline at 1 month post–treatment
* unpaired t–test (p value of 0.05 considered statistically significant)
McMonnies. Adv Exp Med Biol 1998;438:835–8. (lower score = less severe symptoms)
lower score = less severe (minimum 0, maximum 9)
Keywords: cornea: tears/tear film/dry eye • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials