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Effects of Diquafosol Sodium Eye Drops on Tear Film Stability in Short BUT Type of Dry Eye

Shimazaki-Den, Seika MD, PhD; Iseda, Hiroyuki MS; Dogru, Murat MD, PhD; Shimazaki, Jun MD, PhD

doi: 10.1097/ICO.0b013e3182930b1d
Clinical Science

Purpose: To investigate the effects of diquafosol sodium (DQS) eye drops, a purinergic P2Y2 receptor agonist, on tear film stability in patients with unstable tear film (UTF).

Methods: Two prospective studies were conducted. One was an exploratory nonrandomized trial on 39 eyes with dry eye symptoms and short tear film break-up time (BUT), but without epithelial damage. Changes in symptoms, BUT, Schirmer value, and ocular surface fluorescein staining (FS) scores were studied for 3 months. The other was a randomized clinical trial of DQS and artificial tears (AT) in 17 eyes with short BUT. Eyes with decreased Schirmer values (≤5 mm) were excluded. Changes in symptoms, BUT, FS scores, and tear film stability using continuous corneal topographic analysis were studied for 4 weeks.

Results: In the exploratory study, while Schirmer values were not significantly increased, significant improvements in symptoms and BUT were noted at both 1 and 3 months. In the randomized clinical trial, significant improvements in symptoms were noted in the DQS group, but not in the AT group, at 2 weeks. BUT was significantly prolonged in the DQS group at 4 weeks but not in the AT group. No significant changes were noted in FS scores or tear film stability.

Conclusions: DQS improved subjective symptoms and prolonged BUT in eyes with UTF not associated with low tear secretion and ocular surface epithelial damage. Because many patients who have UTF are refractory to conventional treatments, DQS may offer benefits in the treatment of dry eyes.

Department of Ophthalmology, Tokyo Dental College, Ichikawa General Hospital, Chiba, Japan.

Reprints: Seika Shimazaki-Den, 5-11-13 Sugano Ichikawa, Chiba 272-8513, Japan (e-mail:

The authors have no funding or conflicts of interest to disclose.

Received January 02, 2013

Accepted March 19, 2013

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.