The use of non-invasive and invasive diagnostic methods to evaluate the effectiveness of three artificial tear preparations in the treatment of dry eye syndrome

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Dorota Szczęsna-Iskander
Maria Muzyka-Woźniak
Maciej Osęka


Objectives: The assessment of three commercially available artificial tear formulations for dry eye disease (DED) treatment.

Material and methods: This 4-week, randomised prospective study enrolled 30 patients with DED symptoms. Patients received (in scheme 1 : 1 : 1): group 1 – dexpanthenol 2% and hydroxypropylcelulose 0.5%; group 2 – trehalose 3% and sodium hyaluronate 0.15%; group 3 – sodium hyaluronate 0.24%. All assessments were performed before and 28 days after treatment and included Ocular Surface Disease Index (OSDI), subjective symptoms, non-invasive imaging using a cone- and a bowl-type videokeratoscope, Schirmer test and slit lamp exam including fluorescein and lissamine green ocular surface staining. T-test was used for statistical analysis of the results.

Results: All groups had significantly lower OSDI. Four subjective symptoms improved in group 1 and only two subjective symptoms improved in groups 2 and 3. Non-invasive break-up time (NIBUT) was significantly longer after treatment in groups 1 and 3 (p < 0.05). The ratio of tear film surface quality distortion was lower only in group 1 (p < 0.05). Corneal fluorescein staining was reduced in all groups after treatment (p < 0.05). There were no statistically significant changes in Schirmer test, tear meniscus height and NIBUT measured with a bowl-type videokeratoscope after treatment.

Conclusions: All preparations reduced the subjective and objective symptoms of DED. The corneal epithelium and general subjective comfort improved regardless of used artificial tear formulation. Nonetheless, the tear film break-up time change depended on the diagnostic method and treatment type.


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Szczęsna-Iskander D, Muzyka-Woźniak M, Osęka M. The use of non-invasive and invasive diagnostic methods to evaluate the effectiveness of three artificial tear preparations in the treatment of dry eye syndrome. Ophthatherapy [Internet]. 2019Jun.30 [cited 2021Aug.1];6(2):95-104. Available from:


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