Objectives: To evaluate the effect of eye spray phospholipid concentration on symptoms and tear film stability. Methods: High-concentration (Tears Again, Optima Pharma GmbH, Hallbergmoos, Germany) and low-concentration (Ocuvers, Innomedis AG, Germany) phospholipid eye sprays were sprayed onto the closed eyelids of 30 subjects (33.261.8 years; 20 women) in a multicentered, prospective, crossover study. Ocular comfort (visual analog scale) and noninvasive tear film stability (NIBUT) of each eye were evaluated before application (along with the Ocular Surface Disease Index), 10 min after application, and 30 min after application. Results: Comfort (high concentration: 68.5616.4 vs. low concentration: 70.7614.5 phospholipid) and NIBUT (high concentration: 11.564.6 sec vs. low concentration: 11.266.0 sec phospholipid) were not different (P.0.3) between sprays before application, but comfort (by 12 points, P¼0.001) and NIBUT (by 5 sec, P¼0.016) were significantly better with a high-concentration phospholipid spray at both 10 min and 30 min time points than those with the low-concentration phospholipid spray. Conclusions: The liposomal eye spray with higher concentration of phospholipids significantly improved ocular comfort and tear film stability in contrast to the eye spray with lower concentration of phospholipids, hence practitioners need to choose an appropriate eye spray to maximize the patient benefit.
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