The Effect of Long-Term Use of an Eyewash Solution on the Ocular Surface Mucin Layer.

Hiroyuki Yazu,Ayako Shibasaki,Hiroshi Fujishima,Murat Dogru,Naoyuki Kozuki

doi:10.3390/ijms20205078

Hiroyuki Yazu, Ayako Shibasaki + Show 3 more

Open Access

https://doi.org/10.3390/ijms20205078

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Abstract

The use of eyewash solutions in Japan, especially in patients with allergic conjunctivitis and contact lens wearers, has been increasing. Our aim was to investigate how the use of preservative-free eyewash solution in healthy eyes for one month affects corneal safety and ocular surface mucin. We analyzed 42 eyes of 21 individuals (17 males, four females; mean age: 36.1 ± 7.4 years) without ocular allergies, dry eyes, or other ocular diseases through a prospective study. Eyes were randomized to a wash group (group one) and a nonwash follow up group (group two). We evaluated the dry eye-related quality-of-life score (DEQS), tear film breakup time (TBUT), fluorescein staining score, mRNA expression of MUC5AC and MUC16, MUC16 immunohistochemistry, and MUC5AC periodic acid Schiff (PAS) staining. There was a significant decrease in DEQS scores after one month of eyewash use (p < 0.05). There were no significant differences in other evaluation items that were analyzed (all p > 0.05). Furthermore, no significant differences were observed between group one and group two in all endpoints (all p > 0.05). The results suggest that one month use of a nonpreserved eyewash solution has no detrimental effects on the tear film and the ocular surface mucins.

Highlights

The use of eyewash solutions in Japan, especially in patients with allergic conjunctivitis and contact lens wearers, has been increasing
Problems caused by commercial eyewash, for example, infection and dry eyes, have not been reported yet, many physicians are concerned that washing eyes may alter the structure of the mucin in the tear film and may promote infection and epithelial keratoconjunctivitis
This study showed no significant changes in the objective evaluations (TBUT and ocular surface staining) before and after washing the eyes, whereas the subjective evaluation (DEQS) had significantly improved after eyewash

Summary

Introduction

The use of eyewash solutions in Japan, especially in patients with allergic conjunctivitis and contact lens wearers, has been increasing. A cup type eye wash solution, Eyebon® (Kobayashi Pharmaceutical Co., Ltd.; Osaka, Japan) was launched in 1995 triggering wide recognition of eyewash solutions. Eyewash solutions contained preservatives (benzalkonium chloride [BAK]) until 2002. Corneal epithelial disorders associated with the use of eyewash solutions have been reported [1]. We have already reported the ocular safety of nonpreserved eyewash solutions for allergic conjunctivitis [2,3]. Problems caused by commercial eyewash, for example, infection and dry eyes, have not been reported yet, many physicians are concerned that washing eyes may alter the structure of the mucin in the tear film and may promote infection and epithelial keratoconjunctivitis

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