Treatment Of Dry Eye Syndrome Research Articles

Comparison of Efficacy of Omega3 Fatty Acids with Vitamin A and Vitamin C in the Treatment of Dry Eye Syndrome

Background: Dry eye is one of major ocular surface disorders affecting millions of people. The chronic discomfort in these conditions interferes with the quality of life for a long period of time. A typical clinical symptoms of dry eye are ‘burning sensation', 'irritation', and 'ocular fatigue'. Hence the Aim of this research “To compare the efficacy of Omega3 fatty acids with Vitamin A and Vitamin C in the treatment of dry eye syndrome”. Methods: The present study titled “Comparison of efficacy of Omega3 fatty acids with Vitamin A and Vitamin C in the treatment of dry eye syndrome” was conducted in VIMS & RC, Whitefield, Bangalore between January 2013 and July 2014 on the subjects who attended the outpatient department of Ophthalmology at VIMS & RC. This was a interventional and non-observational l study of 100 clinically diagnosed cases of dry eye syndrome after informed consent which satisfied the inclusion and exclusion criteria. Dry eye syndrome diagnosis and severity level of diseases was determined with OSDI scoring, TBUT, Schirmer’s test 1 & 2, Rose Bengal Test and TMH. Results: Results showed that lesser grade of dry eye is seen in patients with higher education, younger age group and with indoor jobs as compared to patients with outdoor jobs who had higher grade of dry eye in our study groups. Improvement was observed in TBUT, Schirmer’1 & 2, Rose Bengal, OSDI score and grade of dry eye in both 2nd study group (CMC + Omega 3 fatty acids) and 3rd study group ( CMC+ Vitamin A&C) as compared to the control group.(P<0.001) This improvement was more significant in 2nd study group as compared to 3rd study group. Conclusion: It was observed that dry eye syndrome was more significantly improved in group2 (CMC + Omega 3 fatty acids) as compared to groups 3( CMC + Vitamin A&C). It was concluded using oral supplementation of omega 3 fatty acids or vitamin A & C would be beneficial for patients suffering from dry eye syndrome.

Fabrication of Konjac glucomannan-based composite hydrogel crosslinked by calcium hydroxide for promising lacrimal plugging purpose.

Swelling, mechanical strength, flexibility, and toughness are important parameters in hydrogel preparation for application in the human body. Herein, composite hydrogels were prepared using a mix of Konjac glucomannan (KGM), sodium alginate (SA), and polyvinyl alcohol (PVA) cross-linked by calcium hydroxide. The PVA/KGM/SA composite hydrogel showed a suitable swelling ratio and rate, as well as elasticity and flexibility. In addition, the elongation at break was 660.3%, with a breaking strength of 87.25 kPa and a compression modulus of 1.660 MPa. Rheological studies showed that the composite hydrogel was composed of a multiply cross-linked network involving chemical and physical interactions, thereby affecting the elasticity and flexibility of the gel. Interestingly, the composite gel network was reformed when the temperature decreased. In rabbit models of dry eye, the hydrogel effectively maintained the normal tear meniscus height and increased the low tear meniscus area. The results therefore showed that the PVA/KGM/SA gels not only provide a simple, effective, and safe method for the preparation of hydrogels, but also have potential applications in the treatment of dry eye syndrome.

Prevalence and severity of dry eye syndrome in myopic candidates for laser in situ keratomileusis

To assess the prevalence and severity of dry eye syndrome (DES) in patients with myopia being evaluated for laser in situ keratomileusis (LASIK). The prospective, non-interventional, cross-sectional study involving 9 Russian ophthalmic centers included 400 patients with myopia (aged 29.7 years in average). Among them, 145 (36.2%) wore contact lenses, and 81 (20.2%) used locally administered drugs for treatment of DES. The examination included Shirmer I test, tear film break-up test (TBUT), staining with lissamine green and fluorescein (Oxford scale), Ocular Surface Disease Index (OSDI) questionnaire, and classification of the disease according to dry eye workshop (DEWS). Average Shirmer test result was 15.2 mm; 36.5% of patients had signs of tear deficiency (Shirmer test ≤10 mm). Average TBUT was 11.7 seconds; the tear film of 10.1% of patients was unstable (TBUT <5 seconds). Lissamine green staining was classified as insignificant or higher (degree ≥I) in 62.3% of patients and mild or higher (degree ≥II) - in 22.8%. Mean score of the OSDI questionnaire was 20.4 indicating mild vision impairment. Dry eye severity according to DEWS classification was mild/episodic in 66.2%, moderate - in 29.5%, and severe - in 4.3% of patients. No clear correlation was evident between the Schirmer/TBUT scores and the lissamine green/OSDI scores. The prevalence of dry eye in this population was estimated at approximately 10% to 40% (based on clinical signs) and 40% to 55% (based on symptoms); dry-eye severity was predominantly mild/episodic. The proportion of patients requiring dry-eye therapy (based on OSDI and DEWS severity findings) was almost 2 times higher than the proportion receiving treatment.

An experimental study of amniotic lacrimal duct stents in the treatment of perimenopausal female rabbits with dry eye.

The aim of the present study was to investigate the effects of an amniotic membrane lacrimal stent in the treatment of dry eye syndrome in a perimenopausal rabbit model. In total, 48 healthy female rabbits were randomly divided into four groups (12 rabbits/group): Group A, sham-operated group; group B, negative control group; group C, sham-implantation group; and group D, implantation with amniotic membrane lacrimal stents. A Schirmer I test (SIT), corneal fluorescein staining, optical coherence tomography angiography and corneal confocal microscopy were conducted and the biomechanical properties of the amniotic membrane were measured prior to and 2, 4 and 6 weeks after the operations. There were marked differences in the amount of tear secretion and the SIT following the operation compared with prior to the operation. The amount of tear secretion of group B and C was significantly reduced (F=8.894; P=0.0017). Compared with groups A, B and C, group D demonstrated a significant increase in the amount of tear secretion and a significant reduction in SIT (P<0.05). However, there was no statistical difference between the tear secretion of the A, B and C groups (P>0.05). The cornea epithelial of groups A and D was significantly thinner compared with groups B and C. The superior part [superior temporal (ST)5, superior (S)5, superior nasal (SN)5, ST6, S6 and SN6] was significantly thinner compared with the central part of the cornea epithelium. The corneal epithelia of all groups were thin in the center and thick at the edge. At 6 weeks after the operation, group D exhibited a markedly decreased number of anterior stromal luminescent cells, compared with groups A, B and C. Furthermore, the bending degree of corneal stromal neural trunks was significantly improved, and the density, branches and curvature of corneal epithelium sub-basal nerves ameliorated to a certain extent (P<0.05). Amniotic membrane lacrimal stents demonstrated specific therapeutic effects on dry eye in perimenopausal female rabbits.

Development of a safe and biocompatible powder to be reconstituted as keystone for dry eye syndrome treatment

Development of a safe and biocompatible powder to be reconstituted as keystone for dry eye syndrome treatment

Cross-linked hyaluronic acid gel occlusive device for the treatment of dry eye syndrome.

PurposeA new cross-linked hyaluronic acid (xlHA) gel occlusive device was assessed for safety and efficacy in the treatment of dry eyes.MethodsThis was an institutional review board-approved, single-site, open-label, prospective study to assess the efficacy and safety of placing the xlHA gel in the lower canaliculus. Seventy-four participants aged 25–95 years with dry eyes, who failed treatment with artificial tears, were included. Patients were assessed with corneal slit lamp examination with fluorescein staining and with Schirmer’s test, breakup time (TBUT), and tear meniscus height (TMH) at baseline, 1 month, and 3 months. Patients were followed at 6 months with a telephone questionnaire. The procedure entailed inserting ~0.2 mL of xlHA gel into each lower lid canaliculus with a syringe and lacrimal irrigator. Patients were followed for adverse events.ResultsSixty-three patients completed the study (48 females, 15 males), with an average age of 67 years. Slit lamp demonstrated improved corneal fluorescein staining. Schirmer’s tests demonstrated an average increase over baseline of 3.67 mm after 3 months. TBUT improved 87% and TMH increased by 57% at 3 months over baseline. All objective measures were statically significant. There was one case of conjunctivitis that resolved and was felt to be an incidental viral infection.ConclusionThe xlHA Occlusive Device offers a new, safe, and effective method to treat dry eyes. It appears to have efficacy for at least 3 months on clinical examination. The xlHA gel demonstrated a good tolerance and safety profile.

Gelatin-epigallocatechin gallate nanoparticles with hyaluronic acid decoration as eye drops can treat rabbit dry-eye syndrome effectively via inflammatory relief.

IntroductionDry-eye syndrome (DES) is a general eye disease. Eye drops are the common ophthalmological medication. However, the ocular barrier makes it difficult to attain high drug bioavailability. Nanomedicine is a promising alternative treatment for ocular diseases and may increase drug content in the affected eye.MethodsTo explore this potential, we constructed nanoparticles (NPs) containing an anti-inflammatory agent for DES treatment. The NPs were made of gelatin–epigallocatechin gallate (EGCG) with surface decoration by hyaluronic acid (HA) and designated “GEH”. The particle size, surface charge, and morphology were evaluated. The in vitro biocompatibility and anti-inflammation effect of nanoparticles were assayed via culturing with human corneal epithelium cells (HCECs) and in vivo therapeutic effect was examined in a DES rabbit’s model.ResultsThe synthesized GEH NPs had a diameter of approximately 250 nm and were positively charged. A coculture experiment revealed that 20 µg/mL GEH was not cytotoxic to HCECs and that an EGCG concentration of 0.2 µg/mL downregulated the gene expression of IL1B and IL6 in inflamed HCECs. Large amounts of GEH NPs accumulated in the cytoplasm of HCECs and the ocular surfaces of rats and rabbits, indicating the advantage of GEH NPs for ocular delivery of medication. Twice-daily topical treatment with GEH NPs was performed in a rabbit model of DES. The ocular surface of GEH-treated rabbits displayed normal corneal architecture with no notable changes in inflammatory cytokine levels in the cornea lysate. The treatment improved associated clinical signs, such as tear secretion, and fluorescein staining recovered.ConclusionWe successfully produced GEH NPs with high affinity for HCECs and animal eyes. The treatment can be delivered as eye drops, which retain the drug on the ocular surface for a longer time. Ocular inflammation was effectively inhibited in DES rabbits. Therefore, GEH NPs are potentially valuable as a new therapeutic agent delivered in eye drops for treating DES.

Sex hormone therapy's effect on dry eye syndrome in postmenopausal women: A meta-analysis of randomized controlled trials.

The purpose of the study to assess the efficacy of sex hormone therapy in the treatment of dry eye syndrome in postmenopausal women.The following electronic databases were searched without language restrictions: PubMed, Embase, Cochrane, and the Chinese Biomedical Database. Two reviewers collected all the literature, which was searched for relevance in English and Chinese from January 1990 to July 2017. Both of the reviewers screened documents independently, identifying the studies that met the inclusion criteria. Then, the included studies were evaluated, and the data were extracted and conversed dependently. Finally, Review Manager 5.3 (offered by the Cochrane collaboration) was used to complete the meta-analysis. An integrated mean difference (MD) with its corresponding 95% confidence interval (CI) was calculated.A total of 358 patients with dry eye were enrolled in 7 randomized controlled trials (RCTs). We observed statistically significant improvements in the Schirmer's test scores (MD, 2.06; 95% CI, 0.74–4.46; I2 = 97%; P = .006) after sex hormone treatment. However, the scores for tear breakup time (TBUT) (MD, 1.28; 95% CI, −1.03 to 4.68; I2 = 99%; P = .21) and the ocular comfort index (OCI) (MD, −1.12; 95% CI, −4.42 to 1.98; I2 = 95%; P = .48) were not improved.This meta-analysis of 7 RCTs suggests that sex hormone therapy may be associated with better Schirmer's test scores. However, no significant differences were detected in the TBUT and OCI test scores. Consequently, sex hormone therapy has a potentially useful role in the effective management of postmenopausal women with dry eye syndrome.

Effect of 5-Oxo-2-Pyrrolidinecarboxylic Acid (PCA) as a New Topically Applied Agent for Dry Eye Syndrome Treatment.

The aim of the study was the evaluation of the suitability of 5-oxo-2-pyrrolidinecarboxylic acid (PCA), also in combination with hyaluronic acid (HA), as artificial tears for treatment of dry eye syndrome (DES). Different aqueous formulations containing 0.10% w/w of PCA were used to determine: (i) ex vivo permeation profile of PCA in isolated rabbit corneas; (ii) in vivo residence time of PCA in the precorneal area of rabbits; and (iii) in vivo ability of PCA to counteract the reduction of tear production in an experimental model of DES induced in rabbits. The pharmacokinetic profile of PCA in tear fluid was characterized by high concentrations immediately after application, followed by a rapid decrease, with half-life values of 17.16 and 22.27 min for solutions containing PCA alone and in combination with HA, respectively, when 100 µL of solutions were instilled. The addition of HA almost doubled the PCA bioavailability minimizing the ex vivo apparent corneal permeability of PCA. A positive Shirmer Test Score (STS) was observed for PCA compared to contralateral eyes at all days of treatment for PCA/HA formulation. PCA provides protection from desiccation probably for its osmoprotective activity and high water–binding capability, and this behaviour was enhanced by HA.

Magic Bullet! Rebamipide, a Superior Anti-ulcer and Ophthalmic Drug and Its Large-Scale Synthesis in a Single Organic Solvent via Process Intensification Using Krapcho Decarboxylation

Rebamipide (1) is a superior drug compared to existing drugs for use in healing of peptic ulcers, gastrointestinal bleeding, and dyspepsia. It is also useful as an ophthalmic drug for the treatment of dry eye syndrome. Process intensification for its synthesis was achieved by (i) averting uncontrollable frothing using Krapcho decarboxylation instead of conventional acid hydrolysis, where uncontrollable frothing became chaotic, (ii) minimizing organic waste generation by using a single organic solvent, and (iii) avoiding anti-foaming agents (n-octanol, acetophenone) and acetic acid. With these trifling modifications, the overall yield of active pharmaceutical ingredient (API) was ≥83% with excellent purity (≥99.89%), and the process meets the metrics of “green” chemistry with an E-factor = 11.5. The developed hassle-free commercial process is viable for multi-kilogram synthesis of Rebamipide (1) as the key step, Krapcho decarboxylation is safe to run at 130–140 °C in DMSO, and it was proved to be effective...

Optimizing acupuncture treatment for dry eye syndrome: a systematic review

sBackgroundIn a former meta-analysis review, acupuncture was considered a potentially effective treatment for dry eye syndrome (DES), but there were heterogeneities among the outcomes. We updated the meta-analysis and conducted subgroup analysis to reduce the heterogeneity and suggest the most effective acupuncture method based on clinical trials.MethodsWe searched for randomized controlled trials (RCTs) in 10 databases (MEDLINE, EMBASE, CENTAL, AMED, SCOPUS, CNKI, Wangfang database, Oriental Medicine Advanced Searching Integrated System (OASIS), Koreamed, J-stage) and searched by hand to compare the effects of acupuncture and artificial tears (AT). We also conducted subgroup analysis by (1) method of intervention (acupuncture only or acupuncture plus AT), (2) intervention frequency (less than 3 times a week or more than 3 times a week), (3) period of treatment (less than 4 weeks or more than 4 weeks), and (4) acupoints (BL1, BL2, ST1, ST2, TE23, Ex-HN5). The Bucher method was used for subgroup comparisons.ResultsNineteen studies with 1126 patients were included. Significant improvements on the Schirmer test (weighted mean difference[WMD], 2.14; 95% confidence interval[CI], 0.93 to 3.34; p = 0.0005) and break up time (BUT) (WMD, 0.98; 95% CI, 0.79 to 1.18; p < 0.00001) were reported. In the subgroup analysis, acupuncture plus AT treatment had a weaker effect in BUT but a stronger effect on the Schirmer test and a better overall effect than acupuncture alone. For treatment duration, treatment longer than 1 month was more effective than shorter treatment. With regard to treatment frequency, treatment less than three times a week was more effective than more frequent treatment. In the acupoint analysis, acupuncture treatment including the BL2 and ST1 acupoints was less effective than treatment that did not include them. None of those factors reduced the heterogeneity.ConclusionsAcupuncture was more effective than AT in treating DES but showed high heterogeneity. Intervention differences did not influence the heterogeneity.

Synthesis of tacrolimus nanocrystals and artificial tears surface modification

Objective To synthesize a dual-function nanodrug with immunosuppression of tacrolimus (FK506) and lubrication of artificial tear carboxymethylcellulose sodium (CMC), and provide a basis for the clinical treatment of dry eye syndrome. Methods The FK506 nanocrystals were prepared by ultrasonic method, and polyallylamine hydrochloride (PAH) and CMC were deposited alternatively on the surface of FK506 nanocrystals using layer-by-layer (LbL) self-assembly technology to prepare the bifunctional nanodrug. The morphology, particle size, surface charge, and composition of the nanodrug were analyzed. Results The particle size of FK506 nanocrystals was uniform, and the FK506-(PAH/CMC)3 was approximately spherical with uneven surface. Zeta potential detection results showed that the charge changed alternatively with the increasing of layer number. The results of laser scanning confocal imaging and infrared spectroscopy showed that PAH and CMC were successfully modified on the surface of FK506 nanocrystals. Conclusion The prepared FK506-(PAH/CMC)3 nanodrug is expected to provide a scientific basis for the combined treatment of dry eye. Key words: Tacrolimus; Nanocrystals; Artificial tear; Dry eyes

Outcomes of Thermal Pulsation Treatment for Dry Eye Syndrome in Patients With Sjogren Disease.

To evaluate the clinical outcomes of thermal pulsation treatment in patients with meibomian gland dysfunction (MGD) and dry eye secondary to Sjogren disease. Twenty-four eyes from 13 patients with previously diagnosed Sjogren disease who presented to our institution with dry eye symptoms and had thermal pulsation treatment were prospectively followed up. Patients underwent comprehensive slit-lamp examination, including MGD grading, gland oil flow, corneal and conjunctival staining scores, and tear break-up time (TBUT). Tear osmolarity was tested before and after treatment. The average patient age was 62.4 years (range, 31-78 yrs); 12 were women and 1 a man. The average meibomian gland oil flow score showed an increase from pretreatment 0.71 to 1.75 at 1 year posttreatment (range 9-15 months) (P = 0.001). The average corneal staining score decreased from a pretreatment grade of 1.04 to a posttreatment grade of 0.36 (P < 0.001). The average conjunctival staining score decreased from a pretreatment grade of 1.5 to a posttreatment grade of 0.48 (P < 0.001). The average tear break-up time improved from 3.8 seconds before treatment to 7.5 seconds after thermal pulsation treatment (P < 0.001). There was no statistically significant change in the tear osmolarity or Ocular Surface Disease Index score. Our findings suggest that MGD is an important contributor to dry eye disease in patients with Sjogren disease and should not be overlooked when considering treatment options. Thermal pulsation is a therapeutic option for patients with Sjogren disease who have MGD and dry eye symptoms. After a single treatment, patients exhibited increased oil flow and tear break-up time with an associated decrease in corneal and conjunctival staining.

Pellevé™ vs Lipiflow™ MGD-Related Dry Eye Treatment Study: The ThermaLid™ Procedure

Objective: To assess the safety and efficacy of the Pellevé Wrinkle Treatment System as compared to LipiFlow, for treatment of dry eye syndrome due to meibomian gland dysfunction (MGD).&#x0D; Materials and Methods: In this split face, randomized study, ten patients who met specific criteria for inclusion were followed after treatment with the Pellevé Wrinkle Reduction System (what the authors have dubbed the "thermaLid Procedure") and a standard LipiFlow procedure performed the same day, with 1 and 3 months follow-up. Pre- and post- treatment MGD was assessed using a variety of subjective and objective measurements. &#x0D; Results: The function of the meibomian glands improved significantly from baseline to 3 months for both thermaLid and Lipiflow treated eyes, with no significant difference between them, as measured by MGE grading, wax plug scoring, Standard Patient Evaluation of Eye Dryness (SPEED) and Ocular Surface Disease Index (OSDI) scoring. A significant change in conjunctival staining was found after both treatments at the 1-month time point but not the 3-month time point. thermaLid but not Lipiflow treatment, significantly decreased MARX line measurements at 3-months. Lipiview, Non-Invasive Tear Breakup Time (NITBUT), corneal surface staining, Tear Osmolarity, and anesthetic Schirmer's testing did not show statistically significant improvement, nor differences between treatment modalities.&#x0D; Conclusions: thermaLid treatment of the eyelids appears to show efficacy similar to Lipiflow treatment in reducing symptoms, reducing wax plugging and improving the number of functioning MGs as well as reducing conjunctival staining in MGD related dry eye disease.

Reflections on Dry Eye Syndrome Treatment: Therapeutic Role of Blood Products.

Dry eye syndrome (DES) is a multifactorial, frequent, pathology characterized by deficient tear production or increased evaporation of tears and associated with ocular surface alteration and inflammation. It mostly affects, but not exclusively, older individuals and leads to varying degrees of discomfort and decreased quality of life. Although the typical treatments of DES rely on using artificial tears, polyunsaturated fatty acids, integrin antagonists, anti-inflammatory agents, or on performing punctal occlusion, recently, standardized blood-derived serum eye drops (SED) are generating much interest as a new physiological treatment option. The scientific rationale in using SED for treating or releasing the symptoms of DES is thought to lie in its composition in multiple factors that resembles that of tears and contributes to the healing and protection of the ocular surface. This manuscript seeks to provide relevant background information on the management of DES, and on the increasing role that various types of SED or platelet lysates, from autologous or allogeneic origins, are playing in the improved therapeutic management of this pathology. The increasing role played by blood establishments in producing better-standardized SED is also addressed.

Ocular complications in a young pediatric population following bone marrow transplantation

To investigate ocular complications associated with bone marrow transplant and associated continued maintenance therapy in a preschool population. The medical records of patients <7years of age were reviewed retrospectively. Patient charts were screened for cataract formation, dry eye, and other anterior and posterior segment disease. Of 270 cases reviewed, 91 met inclusion criteria. Mean age at diagnosis was 3.17years. Average follow-up was 5.8years (range, 1.9 months-14.1years). Of the 91, 37 patients developed cataracts (35 bilaterally) over a 14-year period. Cumulative incidence corrected for competing event (death before cataract) for the study population was found to be 58.4% after 14years. Univariate analysis for cataract formation showed statistical significance for total body irradiation dose, age at diagnosis, race, donor type (related vs unrelated), product type, diagnosis type, survival status, calcineurin inhibitor use, and bisulfan, cytarabine, and thiotepa use. Multivariate analysis for competing event (death), showed that total body irradiation dose was not statistically significant; however, when studied in a binary logistic regression model, total body irradiation dose was statistically significant. Notably, steroid use and presence of graft-versus-host disease did not show statistical significance for cataract development. No other ocular complication was found in sufficient quantities to allow statistical analyses. Due to the high incidence of cataract formation in this population, especially those enduring a treatment regimen with total body irradiation, we propose screening examinations by a pediatric or general ophthalmologist at least annually. We also urge a low threshold for treatment of dry eye syndrome.

Secondary dry eye syndrome after keratorefractive surgeries and approaches to its treatment and prevention

The article reviews the particularities of development and pathogenesis of secondary dry eye syndrome (DES) after refractive surgeries including a complex of problems related to changes in tear film content, damage of eye surface and neurotrophic epitheliopathy. Additionally, modern algorithms of treatment and prevention of secondary DES in patients after refractive surgeries are described. Despite the transient nature of the changes, excimer-laser surgery can lead to lasting deficiencies of eye surface in some patients. Therefore, intensive and early treatment of secondary DES during the early follow-up period after refractive surgery may significantly reduce risks of tear dysfunction and neurotrophic epitheliopathy development in the long term.

Слезозаместители комплексного состава в лечении синдрома «сухого глаза»

60 outpatients with weak and moderate dry eye syndrome were followed in order to perform a comparative efficiency evaluation of three tear replacement drugs: Stillavit, Vismed and Tears naturale. Changes in the condition of the eye were estimated using biomicroscopy data and diagnostic tests (including Schirmer test, Norn test, Lipkof test, lacrimal meniscus height, and fluorescein eye stain test). The patients were divided into 3 groups, each consisting of 20 patients, who respectively received instillations of two drops of the three drugs, 3 times a day for 40 days. The last examination was given on the 60th day of observation period since the drugs had been discontinued. As a result of treatment, positive changes were observed in all three observation groups. A pronounced improvement was achieved in the condition of the eyelids, conjunctiva and the cornea, as well as in the parameters of the diagnostic tests. In weak dry eye syndrome, full-scale moisturizing and formation of stable tear film is recommended, which is achievable with Vismed 0.18 %. In dry eye syndrome complicated by keratopathy, the therapeutic effect of the tear replacement drug must be strengthened by adding keratoprotectors, which is best achieved by the three-component eye solution, Stillavit. For citation: Jani Е.V., Seliverstova К.Е. Tear replacement combination drugs in the treatment of dry eye syndrome. Russian ophthalmological journal. 2018; 11 (3): 63-9 (In Russian). doi: 10.21516/2072-0076-2018-11-3-63-69.

Diagnosis and treatment of dry eye syndrome

Diagnosis and treatment of dry eye syndrome

Improving the topical ocular pharmacokinetics of lyophilized cyclosporine A-loaded micelles: formulation, in vitro and in vivo studies

Dry eye syndrome (DES) is one of the most common disorders of the eye for which combined treatment includes modification of the ocular environment and pathogenic therapies. Cyclosporine A (CsA), a immunosuppressive agent, has been demonstrated to be effective for the treatment of DES but is limited clinically by its low ocular bioavailability due to poor water solubility. In this paper, methoxy poly (ethylene glycol)-poly (lactide) polymer (mPEG-PLA) micelles were investigated as alternative vehicles for the solubilization and delivery of CsA to the eye. The in vitro stability indicated that CsA-loaded micellar lyophilized powder was stable for at least 3 months and the release profile showed a sustained release manner of CsA from micelles physically. In vivo ocular distribution studies demonstrated that the micellar formulations exhibited a 4.5-fold increase in retention effect at eyes compared with 0.05% CsA emulsion. In addition, the in vivo pharmacokinetics profile showed that the CsA-loaded micelles could enhance the retention time, achieving longer effect toward the DES. These studies proposed an effective micelle formulation as a novel ocular drug delivery system to improve solubility and bioavailability of ophthalmic CsA-controlled delivery.