Clinical efficacy of sodium hyaluronate and bFGF eye drops in dry eye and eyes after LASIK

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.

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.

To investigate the clinical effect of sodium hyaluronate eye drops combined with tobramycin, dexamethasone, and pranoprofen eye drops in the treatment of dry eye after phacoemulsification. Medical records of 188 patients with dry eye after phacoemulsification, treated in our hospital from August 2020 to August 2021, were included and divided into groups based on the type of dry eye treatment. Patients in the control group (n = 90) were treated with tobramycin, dexamethasone, and pranoprofen eye drops. Patients in the test group (n = 98) were treated with sodium hyaluronate, tobramycin, dexamethasone, and pranoprofen eye drops. The tear secretion test (TST), film rupture time (BUT), corneal fluorescence staining (FS) score, levels of interleukin (IL)-6, and tumor necrosis factor (TNF)-α before the treatment and at 1 month follow-up, the overall total effective rate and the number of completely cured cases were compared between the two groups. Multiple linear regression was used to calculate coefficients for predicting clinical variables. Ordinal logistic regression was used to compute coefficients and odds ratios for predicting effective scores. The total effective rate in the observation group (99%) was significantly higher than that in the control group (80.00%). After the treatment, the TST and BUT indexes of the observation group were higher compared to the control group, and the FS score of the observation group was lower than that of the control group. TNF-α and IL-6 levels of the observation group were lower compared to the control group. Logistic regression analysis demonstrated that the differences in the effective rate and clinical variables between the two groups remained significant after adjusting for the effect of age. A combination of sodium hyaluronate, tobramycin, dexamethasone, and pranoprofen eye drops for the treatment of dry eye after phacoemulsification can improve the curative effect, reduce corneal fluorescein staining and inflammatory factor index levels compared to the treatment regimen lacking sodium hyaluronate eye drops.

To evaluate the clinical efficiency of the treatment of dry eye disease (DED) with ocular pain using deproteinized calf blood extract (DCBE) eye drops as compared to 0.3% sodium hyaluronate (SH) eye drops. This prospective, single-center, masked (double-blind), randomized controlled study included 53 patients divided into two groups: DCBE (n=22) and SH (n=31) group. The DCBE group received DCBE eye drops for 4 weeks, and the SH group received 0.3% SH eye drops for 4 weeks. Corneal fluorescein staining (CFS) scores, tear break up time (TBUT), Schirmer test and the ocular surface disease index (OSDI) scores were evaluated in all patients before treatment, 2 and 4 weeks post-treatment. The DCBE group showed better improvement in the OSDI light sensitivity scores and ocular pain scores compared with the SH group (P<0.05). At 2 and 4 weeks post-treatment, the DCBE group and the SH group showed significant improvement in TBUT, Schirmer test, CFS, OSDI score, light sensitivity score and ocular pain score (P<0.05) compared with the data from before treatment. This study indicates that DCBE eye drops can relieve ocular pain and light sensitivity in dry eye patients better than SH eye drops.

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 of sodium hyaluronate eye drops, polyethylene glycol eye drops, and compound dextran eye drops in the treatment of dry eye after phacoemulsification of cataract.A total of 99 patients with dry eye after cataract phacoemulsification combined with intraocular lens implantation were treated in our hospital. Patients were divided into group A (sodium hyaluronate eye drops), group B (polyethylene glycol eye drops), and group C (dextran-70 eye drops). The clinical effect, tear film breakup time, basic tear secretion, corneal staining score, dry eye symptom score, and the incidence of ocular irritation were assessed.On the 3rd, 15th, 30th, and 60th day after operation, the tear film breakup time, corneal staining score, Schirmer I test, and dry eye symptom score in group A and group B were better than those in group C (P < .05). In addition, there were no significant differences in tear breakdown time, corneal staining score, Schirmer I test, and dry eye symptom score between group A and group B (P > .05). At 3 days to 60 days after operation, the incidence of dry eye in group A (12.12%) and group B (18.18%) was lower than that in group C (39.39%), and the incidence of dry eye in group A was significantly lower than that in group B (P < .05).The effect of sodium hyaluronate eye drops elicited a greater beneficial impact as compared to polyethylene glycol eye drops and dextran-70 eye drops.

BACKGROUND Dry eye syndrome (DES) after diabetic cataract surgery can seriously affect the patient’s quality of life. Therefore, effective alleviation of symptoms in patients with this disease has important clinical significance. AIM To explore the clinical effect of recombinant human epidermal growth factor (rhEGF) plus sodium hyaluronate (SH) eye drops on DES after cataract surgery in patients with diabetes. METHODS We retrospectively evaluated 82 patients with diabetes who experienced DES after cataract surgery at Tianjin Beichen Hospital, Affiliated Hospital of Nankai University between April 2021 and April 2023. They were classified into an observation group (42 cases, rhEGF + SH eye drops) and a control group (40 cases, SH eye drops alone), depending on the different treatment schemes. The thera-peutic efficacy, dry eye symptom score, tear film breakup time (TFBUT), basic tear secretion score [assessed using Schirmer I test (SIt)], corneal fluorescein staining (FL) score, tear inflammatory markers, adverse reactions during treatment, and treatment satisfaction were compared between the two groups. RESULTS Therapeutic efficacy was higher in the observation group compared with the control group. Both groups showed improved TFBUT and dry eye, as well as improved SIt and FL scores after treatment, with a more pronounced improvement in the observation group. Although no marked differences in adverse reactions were observed between the two groups, treatment satisfaction was higher in the observation group. CONCLUSION rhEGF + SH eye drops rendered clinical benefits to patients by effectively ameliorating dry eye and visual impairment with favorable efficacy, fewer adverse reactions, and high safety levels. Thus, this treatment should be promoted in clinical practice.

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.

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.

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.

Canalicular stenosis caused by inflammatory processes in the mucosa of canalicular causing thickening of the squamous epithelium, subsequently parakeratosis and hyperkeratosis of the squamous epithelium. The aim of this study was to assess the effects of sodium hyaluronate compared with steroid eye drop against the degree of canalicular stenosis in breast cancer patients treated with docetaxel chemotherapeutic agents. This study was a clinical trial with the randomized controlled trial (RCT) of 80 sample during the period August-October 2017. Bivariate analyzes used chi-square and McNemar test, and multivariate analysis used logistic regression with the backward method. A total of 20 samples with moderate degree stenosis became mild degree and 36 samples with mild degree stenosis became not stenosis after treated with sodium hyaluronate eye drops. A total of 16 samples with moderate degree stenosis became mild degree and 36 samples with mild degree stenosis became not stenosis after treated with steroid eye drops. McNemar test showed a significant difference in the degree of stenosis after treated with sodium hyaluronate (p=0.039) and steroid eye drops (p=0.000), but chi-square test showed no significant difference in the degree of stenosis between sodium hyaluronate and steroid (p=0.302). Multivariate analysis showed that age, duration of administration and dose of docetaxel effects in canalicular stenosis. Administration of sodium hyaluronate and steroid eye drops can improve the degree of canalicular stenosis.

Shalakyatantra is one of the branch from the eight part which is concern with the management of disease affecting the regions of the body above the clavicles i.e. Ear, eyes the oral and the Nasal cavities etc. Shushkaakshipaka is vata pitta pradhan sarvagatavyadhi. It can be co-related with dry eye syndrome in modern aspect. Modern science has lacuna in complete curative management of disease. Ancient Ayurved texts e.g., Brihatrayees and Laghutrayees explained ample of therapies regarding management of Shushkaakshipaka. Dry eye syndrome is group of symptoms which includes ocular irritation, redness, tenderness, and dryness. yashtimadhu ghrita is vatapittaghna, chakshushya and having properties of snigdha guna so use of yashtimadhu ghrita tarpana will be beneficial in the management of shushkaakshipaak.&#x0D; Aim: Comparative clinical study of Yashtimadhu Ghrita Tarpan and Sodium Hyaluronate (0.1%) Eye Drop in the management of Shushkakshipaka with special reference to Dry Eye Syndrome. Materials and Method: A total 70 patients of the age group 18-80 years presenting with signs and symptoms of Shushkaakshipaak w.s.r to Dry eye syndrome were selected randomly from OPD of the department of Shalakyatantra. The 35 patients of trial group were treated with Yashtimadhu Ghrita Tarpan and 35 patients of control group were subjected to Sodium Hyaluronate (0.1%) Eye Drop. Results: Yashtimadhu Ghrita Tarpan is more effective as compared to Sodium Hyaluronate (0.1%) Eye Drop. Trial drug provided more relief in most of the symptoms of shushkakshipaka. Conclusion: Yashtimadhu Ghrita Tarpan is an effective, safe and potent treatment of shushkakshipaka w.s.r. to Dry Eye Syndrome.&#x0D; Keywords: Shushkakshipaka, Dry eye syndrome, Yashtimadhu ghrita tarpana, Sodium Hyaluronate (0.1%).

Objective To investigate the clinical effect of subcutaneous injecting the compound anisodine besides the superficial temporal artery combined with danhong iontophoresis in treatment of blepharospasm with dry eye. Methods The clinical data of 64 patients (75 eyes) with blepharospasm and dry eye treated in The Second People′s Hospital of Lianyungang were collected from September 2014 to June 2016. According to the digital table method, the patients were randomly divided into control group and treatment group. Among them, there were 30 cases (34 eyes) in the control group and 34 cases (41 eyes) in the treatment group. 30 cases (34 eyes) enrolled in the control group were treated with oral mecobalamin capsule and sodium hyaluronate eye drops. On the basis of the control group′s treatments, 34 cases (41 eyes) enrolled in the treatment group were treated by injecting the compound anisodine besides the superficial temporal artery combined with Danhong iontophoresis. Before and after treatment, two groups of patients were examined in classification of blepharospasm, SchirmerⅠtest (SIt), breakup time (BUT), and corneal fluorescent staining, respectively. SIt wetted length, BUT, and corneal fluorescein staining scores were presented as mean ± standard deviation(±s), and compared by independent samples t-test between two groups, and compared by paired samples t-test before and after treatment. The intensity of blepharospasm was divided into four grades, and the results were compared by Kruskal-Wallis H rank sum test. The therapeutic effect of blepharospasm was expressed as the number of cases and percentage (%), and the total effective rate was compared by chi square test. Results Before the treatment, the results of SIt, BUT and corneal fluorescent staining in the control group were (2.43±1.17) mm/5 min, (2.67±1.03) s and (5.10±1.71) points; after treatment, they were (10.00±2.99) mm/5 min, (9.10±2.44) s and (1.67±1.15) points, respectively. The results of SIt, BUT and corneal fluorescent staining were compared in the control group before and after treatment, and the differences were statistically significant (t=9.12, 10.26, 5.48; P 0.05). However, comparing the results of SIt, BUT and corneal fluorescent staining between the treatment group and control group, after the treatment, and the differences were statistically significant (t=3.88, 5.00, 2.25; P 0.05). But after the treatment, there was statistical difference in the total effective rate which was 94.12% in the treatment group and 80.00% in the control group (χ2=6.94, P<0.05). Conclusion Subcutaneous injecting the compound anisodine besides the superficial temporal artery combined with Danhong iontophoresis is efficient in the treatment of blepharospasm and dry eye. Key words: Blepharospasm; Dry eye; Compound anisodine; Iontophoresis

PurposeProspective, randomised, open-label, comparative study to evaluate efficacy of trehalose/sodium hyaluronate eye drops for post-operative discomfort and tear film stability in patients undergoing cataract surgery.MethodsPatients with healthy ocular surface, subclinical, or mild dry eye were enrolled. Tear breakup time (TBUT), Schirmer test, dry eye symptoms, corneal fluorescein staining (CFS), and ocular surface disease (OSDI) evaluation were performed pre-operatively and at two and four weeks after surgery. Patients were assigned to receive trehalose/sodium hyaluronate eye drops b.i.d (Group A), or 0.9% unpreserved sodium chloride eye drops b.i.d for 4 weeks (Group B).ResultsOne hundred and thirty-five patients were randomised, 66 patients in Group A (73.2 ± 4.5 years) and 69 patients in Group B (74.3 ± 3.8 years), 60.8% females. Fifteen patients (8 Group A) were lost at follow-up. Pre-operatively, no between-group differences were observed, and TBUT increased in Group A between the pre-operative and 2 and 4 week evaluations and was higher in group A than in Group B at 4 weeks. Schirmer test and CFS showed an improvement only in Group A four weeks post-operatively. In Group A an improvement was observed after two and four weeks in foreign body and puncture sensation, whilst a difference in blinking discomfort was observed after four weeks. In Group B we observed an improvement in puncture sensation two and four weeks after surgery. Mean OSDI scores differences between the two groups were significant at four weeks.ConclusionsTrehalose/sodium hyaluronate eye drops were effective in reducing signs and symptoms of dry eye and improving tear film stability

To compare the effects of FK-506, cyclosporin A (CsA), and sodium hyaluronate (HA) eye drops for the treatment of botulinum toxin B (BTX-B)-induced mouse dry eye. CBA/J mice were randomized into 5 groups. The groups received treatment with eye drops containing 0.025% FK-506 combined with 0.3% HA (FK-506+HA group), 0.025% FK-506 (FK-506 group), 0.05% CsA (CsA group), 0.3% HA (HA group), or 0.9% saline (saline group) 3 days after an intralacrimal gland injection with 20 mU of BTX-B. Tear production, corneal fluorescein staining, blink rate, and the mRNA and protein expression levels of inflammatory cytokines were measured. FK-506+HA eye drops increased tear production and reduced the corneal fluorescein staining scores at all time points after treatment compared with those in the saline group. Compared with those in the saline group, the tear production and severity of corneal epithelial defects in the FK-506 group were significantly improved at weeks 2 and 4. Compared with the saline eye drops, the CsA eye drops ameliorated only tear production and corneal fluorescein staining scores at week 4 after administration. The FK-506+HA, FK-506, and CsA eye drops downregulated the expression of inflammatory cytokines in both the keratoconjunctival tissues and lacrimal glands at week 4. The topical application of 0.025% FK-506 combined with 0.3% HA, 0.025% FK-506, or 0.05% CsA can suppress the expression of inflammatory cytokines and can alleviate the signs of dry eye. Topical application of 0.025% FK-506 combined with 0.3% HA showed the best therapeutic effect and may be a possible therapy for dry eye.