Long term treatment with sodium hyaluronate-containing artificial tears reduces ocular surface damage in patients with dry eye

Abstract

Background/aims: Several studies have reported that sodium hyaluronate is able to improve both symptoms and signs in patients with dry eye but none have demonstrated an improvement of conjunctival epithelial cell abnormalities of the ocular surface. The aim of this study was to explore the effect of sodium hyaluronate-containing eye drops on the ocular surface of patients with dry eye during long term treatment. Methods: A randomised double blind study was undertaken in 86 patients with medium to severe dry eye (that is, rose bengal and/or fluorescein test score of at least 3, tear film break up time <10 seconds, or Schirmer's test <5.5 mm). Patients were treated with either preservative-free sodium hyaluronate or saline for 3 months at a dose of one drop 4-8 times a day. Bulbar impression cytology, slit lamp examinations, and subjective symptoms were evaluated after 1, 2, and 3 months. Impression cytology was considered the primary efficacy parameter of the study. Results: The efficacy analysis was performed on a total of 44 patients who were able to fully adhere to the protocol. After 3 months of treatment sodium hyaluronate improved impression cytology score (p = 0.024 v baseline). At the same time also the difference with respect to placebo was statistically significant (p = 0.036). Study medication was well tolerated and no treatment related adverse events occurred during the study. Conclusions: Sodium hyaluronate may effectively improve ocular surface damage associated with dry eye syndrome.

Tempo de reepitelização corneana com a instilação de colírio contendo hialuronato de sódio e carboximetilcelulose

“…Esse mesmo pensamento clínico pode ser usado no que diz res peito a comparação entre os dois colírios estudados. Estatisticamente não houve diferença significativa da mesma forma que outros relatos, os quais afirmam que apesar das propriedades mucoadesivas mais eficientes do HS, este não torna a reepitelização mais rápida (6,16) . Quando foi comparado o resultado de reepitelização a cada dia, ob servouse diferença significativa a partir de 96 horas.…”

“…A lubrificação ocular também parece ajudar na reepitelização, pessoas com olho seco tendem a ter alterações corneanas e os lubrificantes atuam me lhorando a superfície desse epitélio (5) . Lubrificantes oculares são colírios amplamente usados para dimi nuir sintomas de corpos estranhos, abrasões corneanas e melhorar (6) . Existem vários colírios com essa finalidade, entretanto dois deles chamam atenção pelas suas características farmacêuticas.…”

“…Eles melhoram o filme lacrimal précorneano levando a proteção da superfície ocular que auxilia o processo de reparação celular ocular (6) . Existem vários colírios com essa finalidade, entretanto dois deles chamam atenção pelas suas características farmacêuticas.…”

Hyaluronic Acid in the 3^rd Millennium

“…Many studies have proved the safety and the efficacy of native HA solutions as artificial tears [222,[224][225][226]. More recently, also novel derivatives of hyaluronan with improved mechanical and biological properties are being investigated to formulate eye drops with enhanced ocular residence times.…”

Sjögren syndrome

“…[61][62][63][64] In cases of moderate to severe dry eye disease, cyclosporine drops (0.05%) for six months were shown to lead to remarkable improvement in Schirmer test and corneal staining scores and subjective ocular symptoms (e.g., reduced blurred vision, use of artificial tears). • Keratoconjunctivitis sicca with ocular staining score ≥ 3 (assumes that the patient is not currently using daily eye drops for glaucoma and has not had corneal surgery or cosmetic eyelid surgery in the last five yr)…”