Abstract
Purpose :
To compare the results of the adjuvant use of freeze-dried aloe vera gel and drops with the use of preservative-free lubricants in isolated form in patients with evaporative dry eye disease.
Methods :
A prospective comparative cases series study of 40 patients with evaporative dry eye disease in whom freeze-dried aloe vera gel and drops associated with preservative-free lubricants (Natutears, Oculab) were used in 20 patients (Group A) with another group of 20 patients who only used preservative-free lubricants (group B) in the Research Department of Instituto de Ojos Oftalmosalud, Lima, Perú between October 2017 and May 2018. We included adults patients with evaporative dry eye disease diagnosed according to clinical criteria. A complete ophthalmological examination, measuring visual acuity, refraction, BUT, NIBUT, Schirmer's test, osmolarity, OSDI index, lacrimal meniscus, impression cytology, determination of MMP-9 and IL-2 in the first evaluation, at the first month and 3 months follow up.
Results :
The study is being carried out, 14 eyes of 7 patients have been enrolled until now, 28.57% (2) men, 71.4% (5) women. The mean age was 43.2 (+/- 9.5). 4 patients are being treated in the A Group and 3 patients in the B group by convenience.
In basal measures of Group A the tear meniscus shows an average of 0.266 mm (+/- 0.069), Group B shows an average of 0.31mm (+/-0.062). The NI-BUT average was 7.58 sec (+/- 4.16) in the Group A and 7.32 sec (+/- 3.82) in the average measure in group B.
Eyes with moderate and severe clinical classification show a nucleus /cytoplasm ratio of 1/3 or smaller, a smaller amount of goblet cells (21.3 +/- 4.6) and larger intercellular spaces with basophilic cytoplasm in the baseline. Schirmer test shows an average of 22,4 mm (+/-6.3) in the group A and 19.3(+/- 4.2), OSDI Index questionnaire classified the disease in mild in 4 eyes, moderate in 8 eyes and severe in 2 eyes. All patients show elevated expression of matrix metalloproteinase 9 (MMP-9) and interleukine 2 (IL-2).
Conclusions :
We will update the results with the complete sample and will try to demonstrate that the adjuvant treatment with freeze-dried Aloe Vera in patients with evaporative dry eye disease generates clinical improvement, decreasing of pro-inflammatory mediators (MMP-9 and IL2) and significant improvement of impression cytology.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.