Diquafosol sodium ophthalmic solution for the treatment of dry eye in soft contact lens wearers

Abstract

AbstractPurpose Ocular dryness, experienced by up to 75% of soft contact lens (SCL) wearers, is the main reason for its discontinuation. The aim of the study is to evaluate the efficacy of topical application of diquafosol sodium for the treatment of dry eye in SCL wearers. In addition to clinical tests, we used a wheat germ agglutinin conjugate of fluorescein (F‐WGA) and fluorophotometry to evaluate the glycocalyx in the ocular surface in vivo.Methods Twelve SCL wearers with dry eye symptoms (31.3 ± 6.8 year‐old) were treated with 3% diquafosol eyedrops for 4 weeks. The clinical tests included tear break‐up time (BUT), Schirmer test, fluorescein staining score, and subjective symptoms evaluated by the Dry Eye Related Quality of Life Score (DEQS). Five minutes after a 5% F‐WGA solution was applied to the eye, fluorescent intensities in the central cornea were measured by fluorophotometry.Results When comparing before and after diquafosol treatment for 4 weeks, BUT (3.6±2.2 sec to 5.0±2.1 sec, p=0.003), kerato‐conjunctival staining score (2.8±1.8 to 2.1±1.4, p=0.045) and DEQS score (19.2±12.7 to 10.6±12.5, p=0.0032) showed statistically significant improvements (Wilcoxon signed‐rank test). F‐WGA fluorescent intensities in the central cornea (571.8±227.8 to 794.6±219.4, p<0.0001) significantly increased, and had a significant correlation with BUT.Conclusion Fluorophotometric measurement of WGA staining appears to reflect the glycocalyx in the corneal epithelium, and therefore can be a good indicator of the ocular surface wettability. Topical application of diquafosol sodium improved subjective symptoms of SCL wearers with dry eye, possibly by enhancing tear film stability and reducing damage of ocular surface epithelia.