Dry Eye Symptom Score Research Articles

Impact of lifestyle intervention on dry eye disease in office workers: a randomized controlled trial.

Objectives: To evaluate the effects of a 2-month lifestyle intervention for dry eye disease in office workers. Methods: Prospective interventional study (randomized controlled study). Forty-one middle-aged Japanese office workers (men, 22; women, 19; 39.2±8.0 years) with definite and probable dry eye disease were enrolled and randomized to an intervention group (n = 22) and a control group (n = 19). The intervention aimed at modifying diet, increasing physical activity, and encouraging positive thinking. The primary outcome was change in dry eye disease diagnoses. Secondary outcome was change in disease parameters, including dry eye symptoms, as assessed using the Dry Eye-Related Quality of Life Score, corneal and conjunctival staining scores, tear break-up time, and Schirmer test results. Results: A total of 36 participants (intervention group, 17; control group, 19) completed the study. The number of definite dry eye disease diagnoses decreased from four to none (p =.05), and the dry eye symptom score showed a significant decrease in the intervention group (p =.03). In contrast, the corneal and conjunctival staining scores, tear break-up time, and Schirmer test results did not differ significantly between groups. Conclusions: The 2-month lifestyle intervention employed in this study improved dry eye disease status among office workers, with a considerable decrease in subjective symptoms. Lifestyle intervention may be a promising management option for dry eye disease, although further investigation of long-term effects are required.

Randomized Controlled Study to Investigate the Effect of Topical Diquafosol Tetrasodium on Corneal Sensitivity in Short Tear Break-Up Time Dry Eye.

Complex mechanisms underlie dry eye (DE) symptom provocation. In particular, corneal hypersensitivity may provoke symptoms in short tear break-up time (BUT) DE characterized by tear film instability. We hypothesized that improved tear film stability may alleviate corneal sensitivity in patients with short tear BUT DE. Therefore, we investigated the effect of topical diquafosol tetrasodium (DQS) on corneal sensitivity in unstable tear film DE. This prospective, randomized study included 27 subjects (age: 39.1 ± 8.4years; range: 25-59years) with short tear BUT DE, defined based on the presence of DE symptoms and tear film instability. Subjects were randomly divided into DQS (3% DQS, 12 subjects) and artificial tear (AT; preservative-free AT, 15 subjects) groups. Subjects applied the medication 6 times a day for 5weeks. The perception of touch (S-touch) and pain (S-pain) sensitivity was measured using a Cochet-Bonnet esthesiometer. Tear evaluation, corneal sensitivity, and DE symptoms were compared before and after DQS or AT administration. The correlation between the improvement degrees of corneal sensitivity and DE symptoms following medication was analyzed. DQS significantly improved tear BUT and tear meniscus height (TMH) scores (p < 0.05), while AT significantly improved tear BUT (p < 0.05) but not TMH score. Mean S-pain and DE symptom scores were lower after medication use in the DQS (S-pain and DE symptoms: p < 0.05) and AT groups (S-pain: p = 0.05; DE symptoms: p < 0.05). However, S-touch did not change significantly in either group. A positive correlation was observed between the improvement degrees of S-pain and DE symptoms in the overall subjects studied. Both DQS and AT alleviate corneal hypersensitivity and DE symptoms in eyes with short tear BUT DE. However, DQS seems to be more effective to adjust tear environment, leading to the normalization of corneal sensitivity and DE symptoms. UMIN Clinical Trials Registry Identifier, UMIN000014536.

Comparison on dry eye symptom between scleral tunnel incision and transparent corneal incision in phacoemulsification

Objective To compare dry eye symptom between scleral tunnel incision and transparent corneal incision in phacoemulsification and IOL implantation. Methods The data of 200 eyes of 194 cases with cataract underwent phacoemulsification and intraocular lens implantation were collected. They were divided randomly into the transparent corneal incision group , 100 eyes of 98 cases, and scleral tunnel incision group, 100 eyes of 96 cases. The dry eye symptom and Schirmer I test (SⅠt) after surgery were compared between the two groups. Results The dry eye symptom scores of the two groups were increased and decreased after a period of time.The dry eye symptom scores of the two groups at 1, 7 and 14 days after surgery were significantly higher than those before operation (P 0.05). In scleral tunnel incision group the dry eye symptom scores at 1, 7 and 14 days after surgery were significantly higher than those in transparent corneal incision group (P<0.05). Postoperative SⅠt of two groups were firstly increased and then decreased, and two groups of corneal fluorescein staining scores were decreased after increased (P<0.01). In scleral tunnel incision group SⅠt scores at 1, 7, 14 and 30 days after surgery were significantly lower than those in the transparent corneal incision group (P<0.05). After surgery breakup time (BUT) of two groups were decreased at first and then increased (P<0.01). The BUT in scleral tunnel incision group was significantly higher than that of the transparent cornea group (P<0.01). Conclusion Through scleral tunnel incision phacoemulsification can effectively reduce the influence of stability of tear film in early postoperative period, but the symptom of dry eye is more severe than that with clear corneal incision. The dry eye symptom effect of two incisions is not obvious at the end of the follow-up time. Key words: Phacoemulsification; Lens, intraocular; Scleral tunnel incision; Transparent corneal incision; Dry eye

Comparison of the effect of small incision non-phacoemulsification and phacoemulsification surgery in the treatment of cataract

Objective To compare the effect of small incision non-phacoemulsification and phacoemulsification surgery in the treatment of cataract. Methods 90 patients with cataract were selected and randomly divided into ultrasound group and non-ultrasound group, 45 cases in each group, who received small incision non-phacoemulsification and cataract phacoemulsification surgery, respectively.The effect, dry eye symptom score, tear film breakup time and Schirmer test in the two groups were compared. Results The overall response rate in the ultrasound group(93.33%) was obviously higher than that in the non-ultrasound group(62.22%), the difference was statistically significant(χ2=12.60, P<0.05). The dry eye symptom score[(3.34±0.31)points, (3.13±0.14)points]in the ultrasound group were significantly lower than those in the non-ultrasound group[(3.89±0.26)points, (3.46±0.19)points]at postoperative 1 month and 3 months(t=9.12, 9.38, all P<0.05). After the treatment, the tear film breakup time and Schirmer test[(7.34±0.45)s, (5.56±0.54)min]in the ultrasound group were significantly better than the non-ultrasound group[(5.55±0.42)s, (2.45±0.44)min](t=19.51, 29.96, all P<0.05). Conclusion Phacoemulsification surgery exerts obvious effect in the treatment of cataract and induces non-obvious postoperative dry eye symptoms, it is significantly better than small incision non-phacoemulsification and has clinical significance. Key words: Phacoemulsification; Surgical procedures, minimally invasive; Cataract; Dry eye symptom

Clinical effect of pranoprofen eye drops for mild and moderate dry eye–a multicenter, randomized, controlled clinical trial

Background Nonsteroidal anti-inflammatory drugs are widely used in the treatment of dry eye, but the related multicenter clinical study is lack. Objective This study aimed to evaluate the clinic efficacy of pranoprofen eye drops for dry eye. Methods This study protocol followed the Declaration of Helsinki, and oral informed consent was obtained from each patient prior to entering the cohort. A randomized, open, parallel, controlled, multi-center clinical trial was conducted. Total 1 023 patients with dry eye were enrolled based on the same diagnosis criteria in 58 eye institutes of China from July 2011 to July 2012. The patients was randomized into trial group and control group. The combination of 0. 1% pranoprofe dry drops (4 times per day) with 0. 1% sodium hyaluronate eye drops (4 times per day) was used in the trial group, and only 0. 1% sodium hyaluronate eye drops was used in the same way in the control group. The primary evaluated indexes included corneal fluorescence staining scores and break-up time of tear film (BUT), and secondary outcome measurements were the dry eye symptom scores and palpebral conjunctiva congestion and papilla scores as well as Shirmer Ⅰ test (SⅠt). The best corrected visual acuity (BCVA) and adverse response were compared between the two groups. Results The demography was matched between the two groups (both at P>0. 05). The corneal fluorescence staining scores were 0. 76±0. 66 and 0. 35±0. 54 in 14 days and 28 days after treatment in the trial group, which were lower than 1. 41±0. 58 before treatment (t=24. 439, 37. 236, both at P=0. 000); those in the control group were 0. 84±0. 65 and 0. 45±0. 60 in 14 and 28 days after treatment, with significant reduce in comparison with before treatment (1. 41±0. 62) (t=19. 702, 29. 517, both at P=0. 000). The corneal fluorescence staining score was significantly lower in the trial group compared with the control group in 28 days after treatment (t=8. 384, P=0. 004). The BUT was significantly delayed in 14 and 28 days after treatment compared with before treatment in the trial group (4. 88±2. 40)seconds and (6. 03±3. 25) seconds versus (3. 47±2. 10) seconds (t=-13. 358, -17. 734, both at P=0. 000), and so were the control group ([4. 62±2. 21] seconds and [5. 42±2. 70] seconds versus [3. 50±1. 52] seconds [t=-13. 984, t=-17. 879, both at P=0. 000]). The BUT was longer in the trial group compared with the control group in 28 days after treatment (t=10. 483, P=0. 001). In addition, the scores of dry eye symptom, palpebral conjunctiva congestion and papilla were significantly lower in the trial group than those in the control group in post-treated 14 and 28 days (all at P 0. 05). Conclusions Pranoprofen has a better anti-inflammatory effect on dry eye. The combination of 0. 1% pranoprofe dry drops with 0. 1% sodium hyaluronate eye drops can relieve dry eye symptoms and signs very well, especially in mild and moderate dry eye patients. Key words: Dry eye; Non-steroidal anti-inflammatory drugs; Pranoprofen; Inflammation

Comparison of Two Questionnaires for Dry Eye Symptom Assessment: The Ocular Surface Disease Index and the Symptom Assessment in Dry Eye

The aim of this study was to compare patient-reported symptoms of dry eye disease (DED) as assessed by the Ocular Surface Disease Index (OSDI), a 12-item symptom frequency-based questionnaire, and the Symptom Assessment iN Dry Eye (SANDE), a 2-item frequency- and severity-based visual analog scale. Clinic-based evaluation of a diagnostic test. A total of 114 patients with DED. Patients were administered the OSDI and SANDE questionnaires at baseline and follow-up visits to evaluate DED-related symptoms. The correlations between both questionnaires' scores were evaluated using the Spearman coefficient, and their clinical differences were assessed using Bland-Altman analysis. Baseline and follow-up visit OSDI and SANDE dry eye symptom scores. At the baseline visit, the OSDI and SANDE questionnaire scores were significantly correlated (R = 0.64; P < 0.001). Moreover, a significant correlation was found between changes in the OSDI and SANDE scores from baseline to follow-up visits (R = 0.47; P < 0.001). A Bland-Altman analysis, after score normalization, revealed a difference (bias) of less than 2 centesimal units between the scores of the 2 questionnaires. Data collected from the SANDE questionnaire showed a significant correlation and negligible score differences with those from the OSDI, suggesting that the SANDE visual analog scale-based questionnaire has the potential to provide clinicians with a short, quick, and reliable measure for DED symptoms.

Associations between subjective happiness and dry eye disease: a new perspective from the Osaka study.

ImportanceDry eye disease has become an important health problem. A lack of concordance between self-reported symptoms and the outcome of dry eye examinations has raised questions about dry eye disease.ObjectiveTo explore the association between subjective happiness and objective and subjective symptoms of dry eye disease.DesignThe study adopted a cross-sectional design.SettingAll the employees of a company in Osaka, Japan.Participants672 Japanese office workers using Visual Display Terminals (age range: 26–64 years).MethodsThe dry eye measurement tools included the Schirmer test, conjunctivocorneal staining, the tear film break-up time, as well as the administration of a dry eye symptoms questionnaire. Happiness was measured by the Subjective Happiness Scale.Main Outcome MeasuresDry eye examination parameters, dry eye symptoms questionnaires, and the Subjective Happiness Scale score.ResultsOf the 672 workers, 561 (83.5%) completed the questionnaires and examinations. The mean Subjective Happiness Scale score was 4.91 (SD = 1.01). This score was inversely correlated with the dry eye symptom score (r = -0.188, p < 0.001), but was not associated with objective findings which include conjunctivocorneal staining, low Schirmer test score, or low tear film break-up time. The level of subjective happiness was the lowest in the group without objective results, but reported subjective symptoms of dry eyes (p < 0.05).Conclusions and RelevanceThere is evidence of the relationship between subjective happiness and self-reported symptoms of dry eyes. Findings of this study revealed a new perspective on dry eye disease, including the potential for innovative treatments of a specific population with dry eye disease.

Dry eye symptom severity and persistence are associated with symptoms of neuropathic pain

ObjectiveStudies of patients with non-ocular pain suggest that it is therapeutically useful to identify those with features of neuropathic pain. No data is available, however, on whether this approach has...

Clinical efficacy of 0.1% pranoprofen in treatment of dry eye patients: a multicenter, randomized, controlled clinical trial

Background Dry eye is a multifactorial disease of the tears and the ocular surface. This study aimed to investigate the clinical efficacy of a non-steroidal anti-inflammatory drug, pranoprofen, in the treatment of dry eye. Methods It is a prospective, multi-center, randomized, controlled, parallel group study. One hundred and fifteen patients with mild to moderate dry eye disease (55-60 in each treatment group) participated in this multi-center study. Patients were randomly administered with eyedrops containing 0.1% pranoprofen (PRA) plus 0.1% sodium hyaluronate (SH) or SH only, three times daily for 28 days, followed by a 1-week after treatment observation. Dry eye symptom score (DESS), fluorescein corneal staining (FLCS), tear break-up time (TBUT), and Shirmer 1 tear test (ST1, without anesthesia) were evaluated or conducted before treatment and at each study visit. Conjunctival impression cytology was taken from the patients treated with PRA plus SH before and after treatment and real-time polymerase chain reaction (RT-PCR) was performed to detect the changes of human leukocyte antigen DR (HLA-DR) and intercellular adhesion molecule 1 (ICAM-1). Results Patients treated with PRA plus SH showed gradual improvements of DESS, FLCS, and TBUT. Between-group comparisons of FLCS and TBUT have statistically significant differences from day 14. Good tolerance with no severe adverse events was found in both groups. Patients treated with PRA plus SH had a reduced expression level of HLA-DR and were statistically different after 28 days of therapy. Conclusions The application of PRA at a dose of 0.1% was well tolerated and benefited to the patients with mild to moderate dry eye disease. The underlying mechanism of its efficacy may be associated with the reduction of inflammatory factors of conjunctival epithelial cells.

Peripheral neuropathy and tear film dysfunction in type 1 diabetes mellitus.

Purpose. To compare tear film metrics in patients with type 1 diabetes mellitus (DM) and healthy controls and investigate the association between peripheral neuropathy and ocular surface quality. Methods. Dry eye symptoms were quantified in 53 patients with type 1 DM and 40 age-matched controls. Ocular examination included tear film lipid layer thickness grading, tear film stability and quantity measurement, and retinal photography. DM individuals additionally underwent a detailed neuropathy assessment. Results. Neither mean age nor dry eye symptom scores differed significantly between the DM and control groups (P = 0.12 and P = 0.33, resp.). Tear lipid thickness (P = 0.02), stability (P < 0.0001), and quantity (P = 0.01) were significantly lower in the DM group. Corneal sensitivity was also reduced in the DM group (P < 0.001) and tear film stability was inversely associated with total neuropathy score (r = −0.29, P = 0.03). Conclusion. The DM group exhibited significantly reduced tear film stability, secretion, and lipid layer quality relative to the age-matched control group. The negative correlation between tear film parameters and total neuropathy score suggests that ocular surface abnormalities occur in parallel with diabetic peripheral neuropathy.

Clinical Effectiveness of Topical Cyclosporine A 0.05% After Laser Epithelial Keratomileusis

To evaluate the effect of topical cyclosporine A 0.05% after laser epithelial keratomileusis (LASEK). This retrospective nonrandomized comparative analysis was performed in 40 patients (80 eyes) with myopia who underwent flap-off LASEK. Twenty patients (group A) were treated with topical cyclosporine A 0.05% in combination with conventional treatment, and 20 patients (group B) received conventional treatment only. In each group, 10 patients had preoperative dry eye. Uncorrected visual acuity, refractive error, corneal haze grade, symptom score, and ocular surface parameters were measured in both groups before LASEK and at 1, 2, 4, and 8 weeks postoperatively. There were no significant differences between the groups in postoperative uncorrected visual acuity, spherical equivalent, corneal haze grade, Schirmer test values, and keratoepitheliopathy scores. Group A had lower symptom scores (0.80 ± 0.52 vs.1.35 ± 0.49; P < 0.01) and higher tear film break-up time (BUT) (8.05 ± 1.39 vs. 6.55 ± 1.39 seconds; P < 0.01) compared with group B at 4 weeks after LASEK. In addition, in preoperative dry eye patients, symptom scores and tear film BUT returned to preoperative level at 4 weeks postoperatively in group A, whereas they returned to preoperative level at 8 weeks in group B. Treatment with topical cyclosporine A 0.05% can improve ocular discomfort and increase tear film BUT during the early postoperative period, especially in patients with preoperative dry eye.

Long-term results of treatment with diquafosol ophthalmic solution for aqueous-deficient dry eye

To evaluate the preliminary long-term efficacy of diquafosol ophthalmic solution for aqueous-deficient dry eye. Fifteen patients with mild-to-moderate aqueous-deficient dry eye were enrolled. After a washout period, the patients were treated with 3 % diquafosol ophthalmic solution for 6 months. We assessed 12 subjective dry eye symptoms, corneal and conjunctival staining with fluorescein, tear film break-up time (BUT), lower tear meniscus height measured with anterior-segment optical coherence tomography, Schirmer's testing, and adverse reactions at baseline and 1, 3, and 6 months after the start of treatment. Treatment with diquafosol ophthalmic solution significantly improved dry eye symptoms, corneal staining, BUT, and tear meniscus height at 1 month and maintained the effectiveness for 6 months. Conjunctival staining significantly improved 3 and 6 months after treatment. No significant adverse reactions developed. Prolonged use of diquafosol ophthalmic solution for 6 months produced significant improvement both subjectively (dry eye symptom score) and objectively (ocular staining score and tear function tests) for aqueous-deficient dry eye.

Dry eye syndrome after penetrating keratoplasty

Objective To study postoperative tear changes after penetrating keratoplasty.Methods Penetrating keratoplasty was done in 25 cases (25 eyes),with the healthy eye served as a control group.Dry eye questionnaire,tear break-up time (BUT),basal tear secretion test (SIt),corneal fluorescein staining (FL) examination were observed 3 days before surgery,and 1 week,1 month,3 months and 6 months after surgery.Comparison was done between the two groups.Results At each time point after operation,dry eye symptom score,FL score were significantly higher than that before operation (P =0.029,P =0.018).And the symptoms of dry eye and FL score was higher in the surgery group than that in the control group at each timpoint (P =0.013,P =0.006).At each time point after operation,the BUT was shorter than that before operation (P =0.036),the BUT in surgery group was shorter than the control group (P =0.017).The SIt values increased in the surgery group one week postoperatively.It was lower than the preoperative level in 6 months,but the difference were not statistically significant compared with preoperative one (P ＞ 0.05).Conclusion Understanding tear film changes after penetrating keratoplasty has important clinical significance on postoperative rational medicine treatment and recovery of visual function. Key words: Keratoplasty; penetrating; Dry eye; Tear film

Tear production and drainage after botulinum toxin A injection in patients with essential blepharospasm

To evaluate the clinical manifestations of tear production, distribution and drainage in the essential blepharospasm patients, and to analyse the changes after botulinum toxin A injection in these patients. This prospective study was performed in 23 patients with essential blepharospasm treated with Botulinum neurotoxin A (BoNT-A; Dysport, Ipsen Biopharm, UK) from November 2010 to February 2011. Ocular examinations, including frequency and severity of blepharospasm, tear break up time (BUT), Schirmer's test, lower lid tear meniscus height (TMH) measured by optical coherence tomography (OCT, rtvue software version 3.5; Optovue Inc., Fremont, CA, USA), and dacryoscintigraphy using 99m technetium pertechnetate, were performed before and 2 weeks after BoNT-A injection. We asked all patients about changes in the dry eye symptom score, before and after treatment. Results were analysed with independent t-test using spss software version 12.0 for Windows XP, (SPSS Inc., Chicago, IL, USA). Botulinum neurotoxin A treatment relieved blepharospasm in all patients. Mean injection dose was 38 ± 5.6 units. After injection, mean tear BUT was significantly increased from 4.7 ± 4.9 to 6.6 ± 1.6 seconds (p = 0.001) Lower TMH increased in all three points and most notably at the lateral point (p = 0.05). On dacryoscintigraphy, tear drainage velocity was not affected by BoNT-A treatment. But Tc-99m 50% clearance time in interpalpebral fissure significantly increased from 1564 to 2220 seconds on the time activity curve (p = 0.027). Subjective dry eye symptoms also improved in 16 patients (70%) after injection. Tear film stability and TMH increased, but tear drainage velocity was not affected by BoNT-A treatment. Overall Tc-99m 50% clearance time in interpalpebral fissure significantly increased, and tear storage from mild lateral lower eyelid laxity increased after BoNT-A injection. Botulinum neurotoxin A injection was also effective for combined dry eye symptom in the essential blepharospasm patients.

Influence of single-fraction Gamma-Knife radiosurgery on ocular surface and tear function in choroidal melanoma patients

AimTo evaluate ocular surface and tear function in patients with choroidal melanoma treated with single-fraction radiosurgery.Methods36 patients (median age 62 years; range 26–84 years) were enrolled between 2001 and 2006...

The Effect of Topical Cyclosporine 0.05% on Dry Eye after Cataract Surgery

PurposeTo evaluate the effectiveness of cyclosporine 0.05% for dry eye after cataract surgery.MethodsThirty-two newly diagnosed patients with dry eye syndrome 1 week after cataract surgery received a twice-daily treatment of cyclosporine 0.05% for one eye and normal saline 0.9% for the other. Disease severity was measured at 2 weeks, 1 month, 2 months, and 3 months by Schirmer test I (ST-I), tear film break-up time (tBUT), corneal temperature and dry eye symptom questionnaire (Ocular Surface Disease Index).ResultsBoth groups increased in ST-I and tBUT over time. ST-I in the cyclosporine 0.05% group showed a significant increase at 3 months and tBUT in the cyclosporine 0.05% group showed an increase at 2 and 3 months. The dry eye symptom score was significantly reduced in the cyclosporine 0.05% group.ConclusionsCyclosporine 0.05% can also be an effective treatment for dry eye after cataract surgery.

Dry eye analysis of diabetes with cataract patients after phacoemulsification

Background Cataract phacoemulsification combined with intraocular lens (IOL) implantation is a primary treatment for cataract.However,tear film stability and ocular surface structure are affected after surgery,especially some cataract patients with diabetes.Researches determined that tear film dysfunction is an important causative factor of dry eye.Objective This study was to investigate the change of tear film after phacoemulsification in cataract patient with diabetes.Methods A non-randomized cases-controlled study was designed.Thirty-six cataract patients with diabetes (54 eyes)and matched 32 patients (40 eyes)with age-related cataract were included in this study in Tianjin First Center Hospital from October,2010 to May,2011.Phacoemulsification and IOL implantation was performed on the all patients with the same topical eyedrops in both groups.Dry eye-related symptom was surveyed and scored by questionnaire,and tear film break-up time (BUT),Schirmer Ⅰ test(S Ⅰ t)and corneal fluorescein(FL) were examined 3 days before operation and 1 day,1 week,1month,3 months after operation.Written informed consent was obtained from each patient before entering this trial.Results The percentage with preoperative symptoms of dry eye was 36.2％ and postoperative dry eye symptoms accounted for 75.8％.Significant differences were seen in dry eye symptom score,FL score,BUT value and S Ⅰ t value between the diabetic cataract group and only cataract group as well as among 4 time points(dry eye symptom score:Fgroup =139.347,P =0.000 ; Ftime =342.741,P =0.000 ; FL score: Fgroup =14.073,P =0.000 ; Ftime =332.697,P =0.000 ; BUT value: Fgroup =28.198,P =0.000 ; Ftime =868.364,P =0.000 ; S Ⅰ t value: Fgroup =2.848,P =0.095 ; Ftime =564.017,P=0.000).FL scores of 2 groups were significantly higher in postoperation than those in preoperation (P＜0.05),and those of diabetic cataract group were significantly higher than only cataract group(P＜0.05),but no significant difference was found between postoperation 3 months and preoperation (P＞0.05).BUT was shorter in postoperation than that in preoperation in the diabetic cataract group(P＜0.05).S Ⅰ t values in postoperative 1 day and 1 week were significantly lower than in preoperation in both groups(P＜0.05).However,S Ⅰ t values returned to normal from 1 month through 3 months in both groups(P＞0.05).Conclusions Tear film dysfunction occurs after operationin cataract patient with type 2 diabetes.It is thought that cataract patient with diabetes is susceptible population of dry eye.Dry eye appears more early and severer in diabetes patients after phacoemulsification combined with IOL implantation. Key words: Diabetes; Cataract; Phacoemulsification; Dry eye

Efficacy and Safety of Diquafosol Ophthalmic Solution in Patients with Dry Eye Syndrome: A Japanese Phase 2 Clinical Trial

To investigate the dose-dependent efficacy and safety of diquafosol ophthalmic solution for the treatment of dry eye syndrome. Randomized, double-masked, multicenter, parallel-group, placebo-controlled trial. A total of 286 Japanese patients with dry eye who were prescribed topical diquafosol (1%, n = 96; 3%, n = 96) or placebo ophthalmic solution (n = 94). After a washout period of 2 weeks, qualified subjects were randomized to receive a single drop of 1% or 3% diquafosol or placebo ophthalmic solutions 6 times per day for 6 weeks. The primary outcome measure was fluorescein corneal staining score assessment. The secondary outcome measures were Rose Bengal corneal and conjunctival staining scores, tear break-up time (BUT), and subjective symptom assessment. Safety measures were clinical blood and urine examination and recording of adverse events. Fluorescein corneal staining scores significantly improved with both 1% and 3% topical diquafosol compared with placebo at 4 weeks, respectively (P = 0.037, P = 0.002). There was a dose-dependent effect among the groups. Rose Bengal corneal and conjunctival staining scores also improved significantly with both 1% and 3% diquafosol compared with placebo (P = 0.007 and P = 0.004, respectively). Subjective dry eye symptom scores significantly improved with both diquafosol ophthalmic solutions (P ≤ 0.033), although there were no significant differences in BUT compared with placebo. No significant differences between the treatment groups were observed in relation to the occurrence of adverse events. Both 1% and 3% diquafosol ophthalmic solutions are considered effective and safe for the treatment of dry eye syndrome.

Efficacy of Sodium Hyaluronate and Carboxymethylcellulose in Treating Mild to Moderate Dry Eye Disease

We compared the efficacy and safety of sodium hyaluronate (SH) and carboxymethylcellulose (CMC) in treating mild to moderate dry eye. Sixty-seven patients with mild to moderate dry eye were enrolled in this prospective, randomized, blinded study. They were treated 6 times a day with preservative-free unit dose formula eyedrops containing 0.1% SH or 0.5% CMC for 8 weeks. Corneal and conjunctival staining with fluorescein, tear film breakup time, subjective symptoms, and adverse reactions were assessed at baseline, 4 weeks, and 8 weeks after treatment initiation. Thirty-two patients were randomly assigned to the SH group and 33 were randomly assigned to the CMC group. Both the SH and CMC groups showed statistically significant improvements in corneal and conjunctival staining sum scores, tear film breakup time, and dry eye symptom score at 4 and 8 weeks after treatment initiation. However, there were no statistically significant differences in any of the indices between the 2 treatment groups. There were no significant adverse reactions observed during follow-up. The efficacies of SH and CMC were equivalent in treating mild to moderate dry eye. SH and CMC preservative-free artificial tear formulations appropriately manage dry eye sign and symptoms and show safety and efficacy when frequently administered in a unit dose formula.

Tear Measurement in Prosthetic Eye Users with Fourier-Domain Optical Coherence Tomography

To investigate whether Fourier-domain (FD) optical coherence tomography (OCT) can measure the tear meniscus of anophthalmic patients using prosthetic eyes and to compare the characteristics of normal and artificial eyes. Prospective, nonrandomized, observational case series. Thirty-one patients who had undergone anophthalmic surgery in 1 eye and had been wearing artificial eyes for more than 6 months were included. Subjects with socket inflammation, contracted sockets, or other known lid disorders were excluded. Patients were asked to complete a questionnaire regarding their demographic status and dry eye symptoms before treatment, and FD OCT scanning and the Schirmer test were performed. Three images were obtained by FD OCT on each normal and anophthalmic eye, and the tear meniscus height, tear meniscus depth, and tear meniscus angle were measured with computer calipers. FD OCT was able to visualize the tear meniscus of both normal and artificial eyes. The mean tear meniscus height of artificial eyes was significantly lower than that of normal eyes (200.59 +/- 79.68 mum vs 261.24 +/- 86.17 mum; P < .001). Mean tear meniscus depth, tear meniscus area, and tear meniscus volume also were significantly lower in artificial eyes than in normal eyes. The dry eye symptom score showed significantly negative correlation with tear meniscus height. The Schirmer test results correlated with tear meniscus parameters in normal eyes, but not in artificial eyes. FD OCT is a valuable clinical tool in the evaluation of tear meniscus height in normal and artificial eyes. In addition, tear meniscus height can be a useful clinical parameter that estimates symptoms of ocular dryness and discomfort in both normal and artificial eyes.