New artificial tear benefits patients with dry eye

A product containing carboxymethylcellulose, glycerin, and a preservative (Optive, Allergan), is a valuable option in the management of dry eye disease according to an open-label study evaluating patients who previously used an artificial tear product.

Key Points

Hong Kong-Results of an open-label study evaluating patients who previously used an artificial tear product for treatment of dry eye disease demonstrated that another product, with carboxymethylcellulose, glycerin, and a preservative (Optive, Allergan), is a valuable option in the management of this common and debilitating ophthalmic condition, said Rajesh K. Rajpal, MD, at the World Ophthalmology Congress.

The study was an open-label evaluation that enrolled 50 patients at two centers. Eligible participants had previously used a tear with polyethylene glycol 400, propylene glycol, hydroxypropyl-guar, and borate (Systane, Alcon Laboratories) at least once daily for a minimum of 1 month for the palliative treatment of dry eye-related signs and symptoms.

Assessments performed at 1 month after switching to as-needed treatment with the study drops showed patients benefited with statistically significant improvements in objective measures of dry eye disease and experienced subjective improvement with a significantly reduced frequency of instillation.

Artificial tears

"Artificial tears are a mainstay in the management of the symptoms of dry eye disease, and there are a number of products that patients can use," said Dr. Rajpal, clinical associate professor of ophthalmology, Georgetown University, Washington, DC, and a corneal specialist in private practice with offices in the Washington, DC, metropolitan area.

"[The study drops are] a newer product that is formulated . . . to provide both moisturization and hydration of the ocular surface. [Their] safety, tolerability, and efficacy have been demonstrated in previous studies, and the findings of the present investigation provide added support for recommending [the study drops] to improve symptoms in patients suffering from dry eye disease."

Patients included in the clinical study had to have a diagnosis of dry eye unrelated to any lid abnormalities. The population had an average age of 54 years and were about two-thirds female.

Baseline evaluations

Baseline evaluations included the investigator's measurement of conjunctival staining and an Ocular Surface Disease Index (OSDI). These assessments were repeated at the end of the study, and patients also completed a questionnaire to determine changes in dry eye-related signs and symptoms and vision-related function as well as their treatment preference and frequency of artificial tear use.

The mean conjunctival staining score was significantly improved from 1.43 at baseline to 0.98 after 1 month of treatment with the study drops. The mean OSDI score was also reduced significantly from 46.3 at baseline to 29.7.

Self-assessments

The self-assessments showed that almost 80% of patients agreed that the study drops were effective in providing adequate control of their symptoms and allowed improvement of daily activities. Even higher proportions of patients (~83% to 87%) agreed that treatment with the study drops resulted in improvements in ocular burning, stinging, dryness, and grittiness. Importantly, more than 91% of patients agreed that blurring of vision was not a problem with use of the study drops.

"[The study drops are] formulated to provide 'osmoprotection' and [are] particularly useful in eyes affected by hypertonic stress accompanied by irritation-type symptoms of stinging and burning. [Their] mechanism may help to minimize blur and may contribute to a prolonged duration of symptomatic relief," said Dr. Rajpal.

"At entry into the study, patients reported instilling an average of 3.4 drops per day when using [the previously used drops], while at the end of the month of [study drop] use, the average number of drops instilled per day was 2.9," he said. "In addition, two-thirds of patients reported attaining symptomatic relief for at least 4 hours after instilling [the test drops], including 14% of patients who reported the benefit persisted for 6 to 10 hours."