Abstract
PurposeTo study the treatment efficacy of hyaluronic acid 0.3%, cyanocobalamin (vitamin B12), electrolytes, and P-Plus in menopausal patients with moderate dry eye disease.MethodsThirty female patients of mean age 53.06 ± 5.20 years (45–65) were enrolled in this prospective longitudinal study. Meibomian gland loss assessment was determined using a scale with four levels. The Ocular Surface Disease Index (OSDI) questionnaire, phenol red thread (PRT) test, and tear film break-up time (TFBUT) were also completed by the patients. Tear eye drops were formulated with 0.3 g of sodium hyaluronate, P-Plus ™, vitamin B12, sodium chloride, potassium chloride, calcium chloride, magnesium chloride, and SCO® (stabilized complex oxychloride). After 30 days, the patients were re-evaluated.ResultsThe mean meibomian gland loss percentage was 37.97 ± 19.02 % (7.20 to 88.30%). Before treatment, the OSDI was 22.53 ± 14.03 score points (6.25 to 77.08). Posterior OSDI decreased to 16.26 ± 13.69 score points (0.00 to 70.83) (W = 58.00, P < 0.01). Before treatment, PRT was 10.31 ± 4.48 mm (4.00 to 21.00). Posterior PRT increased to 15.41 ± 6.27 mm (4.00 to 21.00) (W = 1520.50, P < 0.01). Before treatment, TFBUT was 6.23 ± 1.75 s (3.00 to 9.00). The posterior TFBUT increased to 8.10 ± 2.06 s (4.00 to 14.00) (W= 1382.50, P < 0.01).ConclusionThe hyaluronic acid 0.3% and vitamin B12 eye drops effectively decreased dry eye symptoms in menopausal women and improved tear stability and volume.
Highlights
Menopause is associated with the physiological interruption of the ovarian hormonal secretion of estrogen and progesterone
We studied an artificial tear therapy formulated with hyaluronic acid, a compound widely used as an ocular lubricant in isolation or in combination with other substances [15]
meibomian gland (MG) loss assessment was not performed after eyedrop treatment because it has been shown that artificial tears do not alter the MG pattern [21]
Summary
Menopause is associated with the physiological interruption of the ovarian hormonal secretion of estrogen and progesterone. As a consequence of physical and psychological deterioration, the quality of life of menopausal women may be reduced [4]. Dry eye syndrome is a disease characterized by the pathological restructuring of tears and lesions on the corneal surface, which result in symptoms, such as visual discomfort and disturbance, burning, itching, redness, pain, and ocular fatigue, without uniform diagnostic criteria [5]. Maintaining physiological levels of hormones, such as estrogens, is essential to obtain stable tear quality. Estrogen and androgen levels affect the three components of the tear film, the aqueous layer, lipids, and mucin. There is a decrease in the level of many sex hormones that subsequently results in dry eye disease (DED) [6]
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