Effectiveness of a Preservative-Free Eye Drop, Cyclosporine 0.05% Emulsion, and Omega-3 Supplementation as a Fixed Combination in Dry Eye Disease – a Pilot Study

Tokko Ha,Ahmad Al-Awadi ,Sohel Somani

doi:10.18314/ctoy.v1i1.151

Abstract

Purpose: We aim to evaluate the impact of combining a preservative-free drop, cyclosporine 0.05% emulsion, and omega-3 oral supplementation on the signs and symptoms of dry eye in a typical ophthalmic practice.Design: A retrospective case series conducted on patients with dry eye disease.Methods: Patients diagnosed with dry eye in a typical ophthalmology practice were initiated on a fixed combination regimen which included a preservative-free eye drop (I-DROP ® PUR GEL, I-MED pharma), cyclosporine 0.05% ophthalmic emulsion, and oral omega-3 supplement(Dry Eye Omega Benefits®, PRN)for 3 monthsconsecutively. The primary outcome measured was a symptom score using the Canadian Dry Eye Assessment Tool (CDEA). Secondary outcome measure was Non-invasive Keratograph Break-up Time (NIKBUT). Primary and secondary outcomes measured at baseline and 3 months following intervention were compared.Results: Thirty-six patients were included with a female male ratio of 2.6:1 and average age of 64.Patient symptoms improved significantly following the intervention as demonstrated by a lower CDEA score during the second visit compared to the first visit (16.11 vs. 19.50, respectively) (p< .05). NIKBUT scores were also significantly improved as demonstrated by a higher score during the second visit compared to the first in both the right (13.18 vs. 11.44) (p< .05) and left (14.62 vs. 12.78) (p< .01) eyes, respectively.Conclusion: A fixed combination of preservative-free eye drops, cyclosporine 0.05% and omega-3 supplementation may be an effective first line treatment option in alleviating symptoms and improving signs of patients suffering from dry eye.

Highlights

Dry eye disease (DED) affects millions of people worldwide
Preservative-free artificial tears, cyclosporine, and omega-3 supplementation have demonstrated some efficacy in treating DED individually [9,11,12,13,17,18], the purpose of this study was to evaluate the efficacy of a fixed combination of all three drugs in a standardized first line approach for all DED patients that present to a dry eye clinic
≥ 65 years old Results listed in table 2 demonstrate that a fixed combination of preservative-free artificial tears, cyclosporine 0.05% emulsion, and oral omega-3 supplementation for the treatment of DED showed an improvement in both primary and secondary outcome measures

Summary

Introduction

Dry eye disease (DED) affects millions of people worldwide. It is estimated that the prevalence of dry eye disease varies anywhere between 6% and 25% of a population, making it one of the most commonly treated disorders by ophthalmologists [1,2,3,4,5]. Age has been shown to be associated with an increased prevalence of DED [2]. The pathophysiology of DED is multifactorial, caused by either decreased tear production and/or excessive evaporation of tears usually associated with ocular surface inflammation and increased osmolarity of the tear film [6]. Signs and symptoms of DED include dryness of the eyes, irritation, a gritty or foreign body sensation, blurred vision, or photosensitivity. The symptoms of moderate to advanced DED are often very debilitating and may affect the quality of life to the same degree as patients with moderate to severe angina or chronic psoriasis [8]

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