Topical Osmoprotectant for the Management of Postrefractive Surgery-Induced Dry Eye Symptoms: A Randomised Controlled Double-Blind Trial.

R M Hazarbassanov,J A P Gomes,J N Barros,N G T Queiroz-Hazarbassanov

doi:10.1155/2018/4324590

R M Hazarbassanov, J A P Gomes + Show 2 more

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https://doi.org/10.1155/2018/4324590

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Abstract

Background Dry eye disease (DED) is one of the most common complications following refractive surgery. Purpose Evaluate the efficacy of an osmoprotective eye drop (Optive®) for the management of induced DED in refractive surgery patients. Design Double-masked randomised controlled trial. Methods Twenty-two refractive surgery patients oriented to apply FreshTears (FT; n = 13) or Optive (Op; n = 9), topically, QID, for 3 months. Eye exams were performed before surgery (T0) and 1-month (T1) and 3-month (T3) follow-up and consisted of tear film osmolarity, Schirmer 1 test, tear film breakup time (TBUT), fluorescein staining, and ocular surface disease index (OSDI) and patient symptoms questionnaires. Main Outcome Measures Pain and osmolarity. Results Pain increased significantly for FT at T3 (p < 0.05). A reduction in osmolarity was observed at T1 and T3 for Op group (p < 0.01) and at T3 for FT group (p < 0.05). TBUT showed a decrease between T0 and T1 for FT (p < 0.05). Schirmer 1 values increased significantly for Op in T1. Conclusions Op was superior to FT in regard to pain, osmolarity, TBUT, and Schirmer 1. Osmoprotectant solutes, such as L-carnitine, could attenuate inflammation and secondary DED. Osmoprotective lubricants can be effectively applied for the prevention of refractive surgery-related dry eye symptoms and signs.

Highlights

Dry eye disease (DED) is a complex and multifactorial disease, which is reported as a complication in 40 to 60% of refractive surgery patients [1,2,3]
Reduced corneal sensation was proposed as the basis of reduced blinking and tear secretion after laser-assisted in situ keratomileusis (LASIK) surgery, and both can contribute to a state of aqueous deficiency [4]
After LASIK or photorefractive keratectomy (PRK), patients can report significant dry eye for several months, an effect that is due to the section of corneal nerves during surgery [23]

Summary

Introduction

Dry eye disease (DED) is a complex and multifactorial disease, which is reported as a complication in 40 to 60% of refractive surgery patients [1,2,3]. Dry eye disease (DED) is one of the most common complications following refractive surgery. Evaluate the efficacy of an osmoprotective eye drop (Optive®) for the management of induced DED in refractive surgery patients. Eye exams were performed before surgery (T0) and 1-month (T1) and 3-month (T3) follow-up and consisted of tear film osmolarity, Schirmer 1 test, tear film breakup time (TBUT), fluorescein staining, and ocular surface disease index (OSDI) and patient symptoms questionnaires. Op was superior to FT in regard to pain, osmolarity, TBUT, and Schirmer 1. Osmoprotectant solutes, such as L-carnitine, could attenuate inflammation and secondary DED. Osmoprotective lubricants can be effectively applied for the prevention of refractive surgery-related dry eye symptoms and signs

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