Novel Therapies in the Treatment of Dry Eye Disease: A Systematic Review and Meta-analysis

Abstract

Background: Dry eye disease (DED) is a complex, chronic and bilateral disease that results in discomfort, visual changes and instability of the tear film. These are immunosuppressive agents, immunomodulators, anti-inflammatory agents and corticosteroids some of the recent treatment approaches are autologous serum eye drops, stem cell therapy, lipid therapy and so on. This meta-analysis seeks to compare the effectiveness of autologous serum eye drops, stem cell therapy as well as the new lipid-based therapies with the standard water-based artificial tear ocular lubricants in DED. Methodology: PubMed, Cochrane and Embase were performed for the identification of trials published in the past 15 years. Specified data extraction was made on the aspects of study design, sample size, type of emerging therapy, measures of efficacy and the follow-up period. Cochrane risk-of-bias tool was used to assess study quality after modification was made to it. Meta-analysis applied the random-effects model to compare the effectiveness when stated as relative risks or mean differences. Results: Amongst the above, 19 studies were considered suitable for inclusion in the present paper. AEED and stem cell therapy demonstrated a better effect than artificial tear on tear film break-up time (TFBUT) and Ocular Surface Disease Index (OSDI). Lipid-based treatments: here, the emulsion-based treatments seem to be slightly superior to the liposome-based treatments in TFBUT and Schirmer’s tests. To grill heterogeneity, sensitivity analyses were conducted on the findings of the meta-analysis. Conclusion: A similarity comparison of autologous serum eye drops and stem cell therapy shows that all parameters of efficacy for DED patients are significantly higher in the second method for increasing TFBUT and OSDI. Lipid preparations in the form of emulsions are not only viable, thus indicating that such novel therapies can aid in the improvement of DED outcomes. More studies must be conducted to describe longer outcomes and fine-tune working procedures.