Short-Term Changes in Tear Lipid Layer Thickness After Instillation of Lipid Containing Eye Drops

Abstract

Lipid-containing eye drops is increasingly popular in eye clinics to treat dry eye. Tear lipid layer thickness (LLT) changes after instillation of lipid eye drops have not been characterized. We aim to evaluate these changes of LLT using a noninvasive interferometry-based method. Methods: This prospective clinical study was conducted on staff and patients from Singapore National Eye Centre with ad hoc recruitment. Noninvasive tear break up time was measured using the Keratographer 5M. LLTs were measured using a tear interferometer machine before and at 1, 5, and 15 minutes after instillation of lipid-containing drops, either Cationorm unidose or Artelac Lipids. Fluorescein clearance (tear clearance rate) and Schirmer tests were conducted. The tear clearance rate of fluorescein dye was based on the visual examination of the color of a Schirmer strip after 5 minutes, compared against color standards. Results: This study included a total of 84 participants aged ≥21 years. Many were female (92.8%) and Chinese (89.2%). A tear clearance rate of 1/16 was most common (35.7%), whereas 1/128 and 1/32 were uncommon (3.57% each). Schirmer results were 6.5 ± 8.1 mm, and noninvasive tear break up times were 8.12 ± 6.25 mm. Participants with baseline LLT <60 nm had greater changes in LLT after Cationorm instillation, compared with those with an LLT of >60 nm. LLT changes over 15 minutes were not associated with tear clearance rate. Similar results were obtained when using Artelac Lipids. Conclusions: Our results showed that participants' initial LLT affected their responsiveness to lipid-containing eye drops more than other factors. Translational Relevance: Doctors may choose to measure the baseline LLT of patients before deciding whether to prescribe lipid eye drops to patients.

Lipid, Aqueous and Mucin Tear Film Layer Stability and Permanence within 0.15% Liposome Crosslinked Hyaluronic Acid versus 0.15% Non-Crosslinked Hyaluronic Acid Measured with a Novel Non-Invasive Ocular Surface Analyzer

“…Phospholipids are commonly used in the manufacture of liposomes [9] to increase the thickness of the lipid layer. Our results are consistent with studies that show an increase in LLT after the instillation of drops that include lipids in their composition [32,[34][35][36]. However, in the HA group, the thickness of the lipid layer decreased at 30 min (0.50 ± 0.51 degrees on the Guillon Scale) (p = 0.01) and 45 min (0.04 ± 0.55 degrees on the Guillon Scale) (p = 0.70).…”

Hyaluronic Acid and Galacto-Xyloglucan Eyedrop Efficacy in Young-Adult Oral Contraceptive Users of Childbearing Age

“…The women included in the study were taking oral contraceptives that negatively influence lipid production, generating dry eye by evaporation. Currently, it is very common to include lipids in the composition of artificial tears since their efficacy was shown to improve LLT and reduce tear film evaporation [ 34 , 35 , 36 , 37 ]. In our study, no eye drops contained lipids in their composition, and this situation might explain why there were no changes in LLT or an increase in TMH.…”

Immediate Ocular Changes After Light-Emitting Diode Displays Exposure—A Preliminary Study

“…The LLT, blink rates, partial blink ratios and CVS-Q score were further analyzed between participants with high (≥60) and low (<60) baseline LLTs. The cutoff value was 60 nm because previous studies reported that a thin LLT (<60 nm) significantly correlated with DED ( 23 , 29 ). Korb et al investigated how blinking improved LLT and found that subjects with baseline LLT values < or = 60 nm experienced a mean increase of 19 nm of LLT after forceful blinking ( 30 ).…”