A 4-week, randomized, double-masked study to evaluate efficacy of deproteinized calf blood extract eye drops versus sodium hyaluronate 0.3% eye drops in dry eye patients with ocular pain.

Understanding the Dual Dilemma of Dry Eye and Glaucoma: An International Review.

The aim of this study was to evaluate the efficacy of hypotonic 0.18% sodium hyaluronate (SH) eye drops under the clinical settings of the dry eye workshop treatment guideline for mild dry eye disease (DED). This analysis included 60 patients with DED. Patients with level 1 DED were treated with either isotonic 0.1% SH (group 1) or with hypotonic 0.18% SH eye drops (group 2). Patients with level 2 DED were treated with 0.1% fluorometholone, 0.05% cyclosporine A, and either isotonic 0.1% SH (group 3) or hypotonic 0.18% SH (group 4) eye drops. Tear film breakup time (TBUT), Schirmer test, corneal staining with fluorescein, and ocular surface disease index score were recorded at baseline, 1 month, and 3 months after treatment. In group 2, TBUT at 3 months (P = 0.03) and corneal staining scores at 1 and 3 months (P ≤ 0.03) were significantly improved after the treatment compared with baseline scores, whereas these parameters were not changed during the follow-up period in group 1. In groups 3 and 4, TBUT and corneal staining scores at 1 and 3 months, and ocular surface disease index score and Schirmer test results at 3 months after the treatment showed significant improvements compared with the baseline score (P < 0.05). Group 4 patients showed an extended TBUT and an improved corneal staining score (P ≤ 0.01) at 3 months after treatment, compared with the values of group 3. Hypotonic 0.18% SH eye drops seemed to be effective in improving tear film stability and ocular surface integrity compared with isotonic 0.1% SH eye drops in patients with mild DED.

Objective To observe the efficiency and safety of 0.1% sodium hyaluronate(SH)eye drops and basic fibroblast growth factor(bFGF) eye drops in simplex dry eye and dry eye after LASIK. Design Randomized controlled study. Participants 70 cases with simplex dry eye(group Ⅰ) and 40 post-LASIK cases(group Ⅱ) from January 2012 to August 2012. Method There were two subgroups in group Ⅰ and group Ⅱ respectively. 0.1% SH(A) and bFGF(B) eye drops were used randomly, four times a day for 14 days in group Ⅰ and 30 days in group Ⅱ. Changes of symptoms and signs were observed at different times. Dry eye symptoms including asthenopia, foreign body sensation, eye dry, burning sensation, swelling sensation, ophthalmodynia, conjunctiva congestion and photophobia were scored using questionnaire survey. Main Outcome Measures Score of dry eye symptoms, tear break-up time(BUT), Schirmer TestⅠ,corneal fluorescein staining(FL), symptoms changes of self-evaluation. Results Ocular symptoms and signs improved significantly after treatment in both subgroups of group Ⅰ(P0.05). 0.1% SH eye drops was better than bFGF eye drops in improving asthenopia(P=0.006) and ophthalmodynia(P=0.040) at 14 days after treatment(P0.05). SH was better to improve BUT(P=0.055) and Schirmer TestⅠ(P=0.573),and bFGF was better to reduce corneal fluorescein staining(P=0.375), but the different was not significant. Significant change of symptoms in patients using SH eye drops and bFGF eye drops were 94.3% and 78.6%, respectively. In group Ⅱ, there were symptoms in 1and 3 days after LASIK, and improved in 10 and 30 days post-operation. SH eye drops was better than bFGF eye drops in improving foreign body sensation(P=0.004), burning sensation(P0.001), swelling sensation(P=0.005) and conjunctiva congestion(P=0.007). BUT and Schirmer TestⅠ decreased in 10 days after LASIK, but increased in 30 days, than that of 10 days after operation(groupⅡA BUT:P=0.142, Schirmer TestⅠ: P=0.053; groupⅡB BUT: P=0.006, Schirmer TestⅠ: P=0.010). Corneal fluorescein staining aggravated in 10 day after LASIK, and improved in 30 days, with significant differences(groupⅡA P=0.005, groupⅡB P=0.079). There was no significant difference between groupⅡA and groupⅡB in changes of dry eye signs. No side-effect was found during observation. Conclusion SH and bFGF eye drops can facilitate corneal epithelial repair, improve tear film stability, and alleviate various symptoms in simplex dry eye and post-LASIK patients. SH eye drops is better than bFGF eye drops in improving certain symptoms including asthenopia, foreign body sensation, burning sensation, swelling sensation, conjunctiva congestion and ophthalmodynia.

Dry eye disease (DED) is a common ocular surface disorder. Esculin and digitalis possess anti-inflammatory and anti-oxidant properties, which may benefit patients with DED. This study aimed to assess the therapeutic efficacy of esculin and digitalis glycosides (EAD) eye drops, either alone or in combination with 0.3% sodium hyaluronate (SH) eye drops, in treating DED. In this randomized controlled trial, 78 participants with DED (78 eyes) were included and divided into three groups: Group A received 0.3% SH, Group B received EAD, and Group C received 0.3% SH combined with EAD eye drops for 4 weeks. The efficacy of the treatments was assessed at 2 and 4 weeks using the Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), Schirmer I test (SIt), and corneal fluorescein staining (CFS) as primary evaluation metrics. After 4 weeks of treatment, Group A showed a decrease in OSDI and an increase in SIT (p < 0.05). Group B showed a decrease in OSDI score (P < 0.05) and a significant improvement in SIt (P < 0.01). Group C demonstrated a significant increase in both TBUT and SIt values at the 2-week mark. Improvements were noted across all parameters, including OSDI score, TBUT, SIt, and CFS score after 4 weeks of treatment (P < 0.05). The total effective rate for participants in Group C was 88.46%, significantly higher than Group A’s rate of 65.38% (P < 0.05). In conclusion, the combination of EAD eye drops with 0.3% SH eye drops proved more effective than either treatment alone.

To compare the clinical efficacy between penetrating needling of three eye acupoints combined with sodium hyaluronate eye drops and sodium hyaluronate eye drops alone for the treatment of dry eye. A total of 156 patients (312 eyes) with dry eye were randomly assigned to an observation group and a control group, with 78 patients (156 eyes) in each group. The control group was treated with sodium hyaluronate eye drops, one drop per eye, four times daily, for 4 weeks. In addition to the sodium hyaluronate treatment, the observation group received penetrating needling of three eye acupoints. Acupoints included bilateral Cuanzhu (BL2), Sizhukong (TE23), Sibai (ST2), and Jingming (BL1). Needling was performed once daily, four times a week, for 4 weeks. The subjective ocular symptom scores, neuropathic pain symptom inventory-eye (NPSI-Eye) scores, ocular surface disease index (OSDI) scores, corneal fluorescein staining (FL) scores, tear break-up time (BUT), SchirmerⅠtest (SⅠT), central tear meniscus height (TMH), and tear levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were evaluated before and after treatment in the two groups. Clinical efficacy was also compared between the two groups. After treatment, both groups showed significant improvements in subjective ocular symptom scores, NPSI-Eye scores, OSDI scores, FL scores, and reductions in tear IL-6 and TNF-α levels (P<0.01). Additionally, BUT, SⅠT, and TMH were increased significantly in both groups (P<0.01). After treatment, the subjective ocular symptom scores, NPSI-Eye score, OSDI score, FL score, and tear levels of IL-6 and TNF-α in the observation group were lower than those in the control group (P<0.01, P<0.05), while BUT, SⅠT, and TMH were significantly improved compared to the control group (P<0.01). The markedly effective rate and total effective rate in the observation group were 83.3% (65/78) and 100.0% (78/78), respectively, which were higher than 52.6% (41/78, P<0.01) and 92.3% (72/78, P<0.05) in the control group. The penetrating needling of three eye acupoints combined with sodium hyaluronate eye drops can effectively alleviate symptoms of dry eye, reduce inflammatory response, and has superior efficacy to sodium hyaluronate eye drops alone.

Highlight: Computer vision syndrome (CVS) that causes dry eyes becomes a health problem for college students. Sodium hyaluronate eyedrops can be used as one of the CVS therapy strategies for students suffering from CVS. Abstract: The use of computers and mobile devices is increasing. Computers and mobile devices help our daily work or study. However, prolonged use of them may cause computer vision syndrome (CVS). Nowadays, CVS becomes a health problem for everyone working with computers or mobile devices including college students because it causes dry eyes. It may disrupt reading, doing professional work, or using a computer which is important for college students to complete academic tasks. Sodium hyaluronate can be used to overcome the dry eye problem due to CVS. To assess the effectiveness of sodium hyaluronate eyedrops on students suffering from CVS, pre- and post-administration of sodium hyaluronate was measured for two weeks. Inclusion criteria for this study were college students aged 20-35 years, using a computer for &gt;2 hours a day, not using nonsteroidal anti-inflammatory drugs (NSAIDs), not consuming drugs, or having a disease that affects tear production and bearing no pregnancy. Parameters assessed include tear break-up time using the Tear Break-Up Time (TBUT) test, tear production using the Schirmer I test, the number of clinically subjective symptoms, and Ocular Surface Disease Index (OSDI) scores. Data were analyzed using student paired t-tests or Wilcoxon Rank Test. There were statistically significant differences before and after the TBUT (4.4 vs 6.7 seconds; p&lt;0.0001); the Schirmer I Test (4 vs 6 mm; p&lt;0.05), and the number of clinically subjective symptoms (3 vs 0 clinically subjective symptoms; p&lt;0.0001). The OSDI scores did not show statistical differences before and after administration of sodium hyaluronate (27 vs 21; p&gt;0.05), but there was a positive impact from moderate to mild dry eye. Sodium hyaluronate eyedrops can be used as one of the CVS therapy strategies for students suffering from CVS.

Aim of this study was to compare the efficacy of sodium hyaluronate (SH) and carboxymethyl cellulose (CMC) eye drops in treating mild to moderate dry eye disease in terms of relief of symptoms, mean change in tear film breakup time, Schirmer's test, and impression cytology of conjunctiva from baseline. An observational study was carried out during a 2-year period in our tertiary referral hospital. The study consisted of 60 patients randomly allotted to two groups to receive SH and CMC eye drops for an 8-week period. Ocular surface disease index, tear film breakup time, and Schirmer's test were performed at baseline visit and 4 and 8 weeks of treatment, and impression cytology of conjunctiva was performed at baseline and 8 weeks. Significant improvement in patient symptoms, tear film breakup time, and Schirmer's test from baseline was seen in both SH and CMC groups at 8 weeks posttreatment, whereas impression cytology of conjunctiva in both groups did not show significant improvement at 8 weeks of treatment. Data analysis using unpaired t-test showed comparable results. Both CMC and SH demonstrated equal efficacy in treating mild to moderate dry eye disease.

BackgroundThe management of post-refractive surgery dry eye disease (DED) can be challenging in clinical practice, and patients usually show an incomplete response to traditional artificial tears, especially when it is complicated with ocular pain. Therefore, we aim to investigate the efficacy of combined topical 0.05% cyclosporine A and 0.1% sodium hyaluronate treatment in post-refractive surgery DED patients with ocular pain unresponsive to traditional artificial tears.MethodsWe enrolled 30 patients with post-refractive surgery DED with ocular pain who were unresponsive to traditional artificial tears. Topical 0.05% cyclosporine A and 0.1% sodium hyaluronate were used for 3 months. They were evaluated at baseline and 1 and 3 months for dry eye and ocular pain symptoms and objective parameters, including Numerical Rating Scale (NRS), Neuropathic Pain Symptom Inventory modified for the Eye (NPSI-Eye), tear break-up time (TBUT), Schirmer I test (SIt), corneal fluorescein staining (CFS), corneal sensitivity, and corneal nerve morphology. In addition, tear levels of inflammatory cytokines and neuropeptides were measured using the Luminex assay.ResultsAfter 3 months of treatment, patients showed a statistically significant improvement in the ocular surface disease index (OSDI), TBUT, SIt, CFS, and corneal sensitivity (all P < 0.01) using linear mixed models. As for ocular pain parameters, the NRS and NPSI-Eye scores were significantly reduced (both P < 0.05) and positively correlated with the OSDI and CFS scores. Additionally, tear IL-1β, IL-6, and TNF-α levels were improved better than pre-treatment (P = 0.01, 0.03, 0.02, respectively).ConclusionIn patients with post-refractive surgery DED with ocular pain, combined topical 0.05% cyclosporine A and 0.1% sodium hyaluronate treatment improved tear film stability, dry eye discomfort, and ocular pain, effectively controlling ocular inflammation.Trial registrationRegistration number: NCT06043908.

There is still no established therapeutic solution for postoperative Dry Eye Syndrome (DES) after cataract surgery, in spite of progress in surgical techniques. Diquafosol tetrasodium (DQS), a recently developed ophthalmic solution, has been reported to be effective in DES, but no study evaluated post-cataract surgery lipid layer thickness (LLT) changes in healthy patients who used DQS postoperatively. We randomly divided participants into two groups; the DQS group was treated six times daily with DQS after cataract surgery, and the sodium hyaluronate (HA) group was treated with HA in the same way. Throughout study period, the DQS group showed significantly higher tear break up time (TBUT) and LLT than HA group. In multivariate analysis, better preoperative TBUT, Schirmer’s I test score, ocular surface disease index (OSDI) score, and LLT were significantly associated with improved postoperative outcomes in each parameter. Also, the postoperative use of DQS served as an independent parameter of better TBUT, OSDI score, and LLT in postoperative 15 weeks. Treatment with 3% DQS following cataract surgery showed more improvement in TBUT and LLT, compared with 0.1% HA. Improving TBUT and LLT preoperatively and using 3% DQS postoperatively, could be a reliable choice for managing DES after cataract surgery.Trial Registration: ISRCTN registry with ISRCTN 18755487.

Objectives This study aimed to assess the effectiveness and safety of intense pulsed light (IPL) therapy plus topical 0.05% cyclosporine A (CsA) eye drops to treat Sjögren’s Syndrome-related dry eyes (SS-DE). Research design and methods In this prospective, randomized trial included, 60 individuals with SS-DE symptoms were randomized to receive topical eye drops containing either 0.1% sodium hyaluronate (Group S) or 0.05% CsA (Group C) plus IPL therapy. Before the first treatment (baseline), and at 12, 16, and 20 weeks after treatment commencement, we assessed the best corrected visual acuity (BCVA), the Ocular Surface Disease Index (OSDI) score, the Schirmer I test (SIT), noninvasive tear breakup time (NBUT), corneal fluorescein staining (CFS), meibomian gland (MG) dropout, lid margin abnormality, MG expressibility, and meibum quality. Results Both groups showed significant improvements in the OSDI, NBUT, CFS, MG expressibility, and meibum quality (all p < 0.05). Group C showed a greater increase in OSDI, NBUT, MG expressibility, and meibum quality (all p < 0.05). Moreover, SIT and lid margin abnormalities significantly improved in Group C (both p < 0.05), but not in Group S. Conclusion Treatment with 0.05% CsA eyedrops plus IPL therapy could significantly reduce the issues and physical discomfort of patients with SS-DE. Clinical Trial Registered on 20 July 2021, with the registration number ChiCTR2100049059.

Objective: To compare the efficacy of dexpanthenol/ sodium hyaluronate fixed combination with sodium hyaluronate eye drops in the treatment of dry eye disease (DED) and ocular surface inflammation (OSI) following cataract surgery. Material and Methods: Sixty-three patients who underwent cataract surgery were included in this study. In addition to the standard postoperative treatment, one group (study group, n=30 eyes) received dexpanthenol/sodium hyaluronate fixed combination eye drops, while the other group was given sodium hyaluronate eye drops (control group, n=33 eyes). The 2 groups were compared in terms of best-corrected visual acuity, tear break-up time (TBUT), corneal flourescein staining, ocular surface disease index (OSDI) and in vivo confocal microscopy (IVCM) findings. Results: While TBUT was significantly greater in the study group than the control group (11.2, 8.9, respectively), corneal floresein staining (0.13, 0.48, respectively) and OSDI (10.8, 17.1, respectively) were significantly lower in the study group compared to the control group at postoperative 4 months. In IVCM, the number of dendritic cells and activated keratocytes were significantly lower in the study group (40.8, 13.9 respectively) compared to the control group (51.2, 18.0, respectively). In addition, while the total number of nerves in the study group (4.57) was higher than that of the control group (3.91), the nerve tortuosity was lower in the study group (1.57, 2.18, respectively). Conclusion: Dexpanthenol/sodium hyaluronate fixed combination eye drops could be preferred as an adjuvant for the treatment of DED and OSI following cataract surgery.

The objective of this double-masked, placebo-controlled, randomized trial was to assess the efficacy and safety of bevacizumab 0.05% eye drops in dry eye patients. This study included Dry Eye Workshop Study (DEWS) Grade 3–4 dry eye participants (n = 31) whose tear break-up time (TBUT) was ≤5 seconds(s). Participants were randomized to undergo treatment with either bevacizumab 0.05% eye drops (n = 19) or placebo (n = 12). The primary outcome was TBUT, and the proportion of responders (increase of ≥3s in TBUT at week 12), ocular surface disease index (OSDI) score, Schirmer test, and Oxford scheme grade were secondary outcomes. All outcomes were measured at 1-, 4- and 12 weeks. TBUT in bevacizumab group differed significantly from TBUT in placebo group within 12 weeks (P = 0.001). Moreover, the improvement of TBUT in bevacizumab group versus placebo group at 4- and 12 weeks differed significantly from that difference at baseline (P = 0.002 and P = 0.003, respectively). The proportion of participants achieving increase of 3 seconds or more of TBUT at week 12 in the bevacizumab group was significantly greater than that in the placebo group (P = 0.02). Oxford scheme grade at 1-, 4- and 12 weeks differed significantly from the values at baseline in bevacizumab group (P = 0.001, P = 0.01, and P = 0.03, respectively). OSDI scores at 1-, 4- and 12-week follow-ups were significantly lower than that at baseline in bevacizumab group (P<0.001 at each follow-up). Schirmer test were not significantly different within or between groups (the lowest P = 0.92). No adverse events occurred in this study. Patients treated with bevacizumab 0.05% eye drops showed significant improvement in tear film stability, corneal staining and symptoms.

ABSTRACTPurpose: To compare the efficacy of 0.3% hypotonic and isotonic sodium hyaluronate (SH) eye drops in the treatment of experimental dry eye.Methods: Experimental dry eye was established in female C57BL/6 mice by subcutaneous scopolamine injection and an air draft. The mice were divided into three groups (n = 15): control, preservative-free 0.3% isotonic SH, and preservative-free 0.3% hypotonic SH. The tear volume, tear film break-up time, and corneal fluorescein staining scores were measured 5 and 10 days after treatment. After conjunctival tissues were excised at 10 days, the levels of interleukin (IL)-6, IL-17, interferon (IFN)-γ, and IFN-γ inducible protein-10 were determined using the multiplex immunobead assay. In addition, PAS staining and flow cytometry were performed to evaluate the counts of conjunctival goblet cells and CD4+ IFN-γ+ T cells.Results: Mice treated with 0.3% hypotonic SH showed a significant decrease in corneal staining scores (P = 0.04) and the levels of IL-6 (16.7 ± 1.4 pg/mL, P = 0.02) and IFN-γ (46.5 ± 11.5 pg/mL, P = 0.02) compared to mice treated with 0.3% isotonic SH (IL-6; 32.5 ± 8.8 pg/mL, IFN-γ; 92.0 ± 16.0 pg/mL) at day 10. Although no significant difference in CD4+ IFN-γ+ T cell numbers was observed, goblet cell counts were higher in the hyopotonic SH group than in the isotonic SH group (P = 0.02).Conclusions: When compared to 0.3% isotonic SH eye drops, 0.3% hypotonic SH eye drops can be more effective by improving corneal staining scores, decreasing inflammatory molecules, and increasing goblet cell counts for experimental dry eye. These data suggest that hypotonic artificial tears may be useful as an adjunctive treatment for inflammatory dry eye.

Purpose: To investigate the efficacy and adverse effect of cyclosporine combined with sodiumhyaluronate (SH) eye drops on dry eye syndrome (DES).Methods: 148 patients with DES treated in Nanjing Drum Tower Hospital Group Suqian Hospital,Jiangsu Province, China between January 2022 and February 2023 were randomly assigned to control(70 cases) and study groups (78 cases). Control group was treated with SH eye drop (1 drop each onboth eyes 5 - 6 times a day, for 2 months), while study group was treated with both SH (the samedosage and use with control group) and cyclosporine eye drop (1 - 2 drops each for both eyes, 4 - 6times a day, for two months). Tear film stability indices such as schirmer I test (SIT), tear break-up time(BUT) and corneal fluorescein stain (FL) of both groups were analyzed before and after therapy.Results: There was no significant difference in BUT, SIT and FL score between the two groups beforetreatment. Compared with before treatment, BUT and SIT increased significantly (p &lt; 0.05), while FLscore dropped significantly in both groups after treatment (p &lt; 0.05). After treatment, study groupshowed significantly higher BUT and SIT levels, and significantly lower FL score than control group (p &lt;0.05).Conclusion: The combination of cyclosporine eye drops with SH eye drops is effective in treating DES.This combination regimen protects tear film stability, effectively alleviates DES symptoms, improvesocular surface and meibomian gland function, and also increases lacrimal river height, withoutincreasing adverse reactions. Further studies will be required, to provide more evidence for clinicalapplication of this combination regimen.

This study evaluates the efficacy and safety of autologous serum eye drops (ASEDs) combined with sodium hyaluronate in treating dry eye disease (DED) after phacoemulsification cataract surgery. This retrospective cohort study included patients diagnosed with DED within 1 week to 1 month after cataract surgery at our hospital (August 2022-July 2023). Patients were divided into a combined group (ASEDs + sodium hyaluronate, n = 48) and a monotherapy group (sodium hyaluronate only, n = 63). Propensity score matching was used to balance baseline characteristics, resulting in 48 patients in each group. Both groups were treated for at least 4 weeks. Clinical indicators, including Ocular Surface Disease Index (OSDI), Schirmer I test (SIT), tear breakup time (BUT), fluorescein staining, conjunctival hyperemia, and conjunctival impression cytology, were assessed before and after treatment. After propensity score matching, baseline characteristics were comparable (P > .05). The mean age was 43.83 ± 8.84 years in the combined group and 43.93 ± 8.84 years in the monotherapy group (P = .865), with male proportions of 47.9% and 45.8%, respectively (P = .779). Other variables, including body mass index, disease duration, OSDI, SIT, and BUT, also showed no significant differences. After 4 weeks, the combined group showed significantly greater improvements. OSDI scores decreased to 14.09 ± 4.22 versus 21.50 ± 4.82 (P < .001); SIT increased to 10.23 ± 2.00 mm versus 8.50 ± 1.50 mm (P < .001); BUT extended to 8.18 ± 0.96 seconds versus 6.00 ± 1.00 seconds (P < .001). Fluorescein staining scores reduced to 0.56 ± 0.22 versus 1.86 ± 0.76 (P < .001), with conjunctival hyperemia and conjunctival impression cytology scores also significantly improved in the combined group (P < .001). ASEDs combined with sodium hyaluronate significantly improve both symptoms and ocular surface parameters in post-cataract DED patients, showing superior efficacy over monotherapy and promising clinical value.