Efficacy of 0.01% dexamethasone solution in comprehensive therapy of dry eye disease

Abstract

Introduction. The officinal dosage of dexamethasone solution (0.1%) has a marked localized antiinflammatory effect. But the widespread use of this dose in the management of dry eye diseases is limited by the risk of damage to the cornea. Therefore, the authors developed a solution containing 0.01% dexamethasone phosphate in combination with 6% polyvinylpyrolidone and 1.5%–5.5% dextrose [3]. Aim. To study the effects of this novel anti-inflammatory solution on corneal inflammatory processes. Materials and methods. This study included a cohort of 25 patients (50 eyes) with corneal–conjunctival xerosis. Lower tear meniscus index, precorneal tear film production, stability and osmolarity, and the degree of staining of the ocular surface epithelium with vital solutions were assessed prior to the treatment and on day 28 of the study. The presence of the cytokines IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-17A, IL-1Ra, TNF-α, INF-α, and INF-γ in patients’ tear fluid and blood plasma was quantified using ELISA. All patients were asked to complete a questionnaire to evaluate subjective signs of xerosis of the ocular surface. Results. Statistically significant increases in tear meniscus index, precorneal tear film stability, and main and total tear production, with a significant decrease in tear film osmolarity were observed by day 28 of the study. In addition, positive changes in objective parameters relating to the ocular surface epithelium were further confirmed by the patients’ evaluations of their quality of life. Furthermore, the degree of staining of the ocular surface epithelium with vital solutions also decreased. Conclusions. The results of the study demonstrate the high level of effectiveness of the developed medication as a treatment for dry eye diseases of various etiologies.