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Fort Lauderdale, FL-Both a corticosteroid (loteprednol etabonate ophthalmic suspension, Lotemax, Bausch & Lomb) and an oil-in-water emulsion (Soothe Emollient Eye Drops, Alimera Sciences) effectively minimized or eliminated lid wiper epitheliopathy findings and symptoms during an initial treatment period of 5 to 10 weeks. The oil-in-water emulsion regimen without corticosteroids controlled lid wiper epitheliopathy findings and symptoms in an extended 1-year study.
"Although the precise cause(s) of lid wiper epitheliopathy remain to be determined, the most probable is tear film dysfunction compromising lubrication between the lid wiper and the ocular surfaces," according to John P. Herman, OD, who reported the findings of his group at the annual meeting of the Association for Research in Vision and Ophthalmology. "The initial treatment of lid wiper epitheliopathy should include both a corticosteroid and a lubricant with the properties of Soothe. Long-term management can usually be achieved with a lubricant without using a corticosteroid."
Only two studies have reported on the treatment of lid wiper epitheliopathy. In one, Dr. Herman and associates1 evaluated two ocular treatment regimens: a corticosteroid eye drop and an oil-in-water metastable emulsion. In the second study, Yamada et al.2 reported poor efficacy of a combination of fluoromethalone (0.1%), artificial tears, and hyaluronic acid eye drops for 1 month. Only two of 18 eyes were successfully treated with this therapy.