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Judith Flanagan, Jennie Diec, Nisha Yeotikar, Daniel Tilia; Transdermal application of glycerol monolaurate ointment improves signs and symptoms of dry eye disease. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1248.
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© ARVO (1962-2015); The Authors (2016-present)
To determine efficacy of transdermal glycerol monolaurate (GML) on signs and symptoms of dry eye disease (DED)
Participants (55; 78% female) with ≥1 expressible meibomian gland, and DED symptoms score >12 (OSDI) were randomly assigned to GML ointment (Lactic Acid 2%, GML 1% in petrolatum) or Control (White Petrolatum). Ointment was applied around the eye twice daily for 6 weeks. OSDI, blepharitis, meibum quality (MQ), meibomian gland expressibility (GE) were graded. Subjects were monitored at Wk1, 3 and 6 for changes relative to baseline (BL). Data were summarised as means±SD for variables on interval scales. Categorical variables were summarised as percentages. Subjective ratings and clinical grades were analysed using linear mixed models. Trial group differences were analysed at each visit if there was a significant interaction. Post hoc multiple comparisons were adjusted using Bonferroni’s correction.
There was no significant difference at BL between groups for any demographic, or physiological variable (all p>0.05). Significant reduction in OSDI was observed at Wk1 for both GML ointment and Control (p=0.001). Relative to Wk1, by Wk6 GML ointment showed further improvement in OSDI (>65%, p=0.003) and GE (p=0.003) and approached significance in improvement in blepharitis (p=0.051) with no such improvements in Control. GML ointment showed greater improvement in OSDI at all visits compared to Control (p≤0.038). For subjects presenting with severe disease (≥4 out of 5 clinical signs) there was significant improvement in OSDI from BL over 6 weeks with GML (p=0.009) with >72% improvement relative to BL, and worsening with Control (p=0.048). Compared to Control, OSDI Items relating to increased evaporation were significantly improved with GML ointment: windy conditions (p=0.035), low humidity (p=0.030), air conditioning (p=0.022). By Wk6, >93% subjects showed improvement with GML ointment for those subjects with worse BL GE (>1) (p=0.001) and >4 clinical signs (p=0.003) with no such improvement in Control.
Despite >84% of subjects presenting with only mild DED, the GML group achieved a minimal clinically important difference over 6 weeks, effecting improvement in signs and symptoms relative to degree of DED at BL suggesting greater benefits relative to worse dry eye at presentation.
This is a 2021 ARVO Annual Meeting abstract.
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