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Additive Effect of Preservative-free Sodium Hyaluronate 0.1% in Treatment of Dry Eye Syndrome With Diquafosol 3% Eye Drops

Hwang, Ho Sik MD, PhD*; Sung, Yoon-mi MD; Lee, Weon Sun BS; Kim, Eun Chul MD, PhD

doi: 10.1097/ICO.0000000000000213
Clinical Science

Purpose: The aim of this study was to evaluate the treatment effect of diquafosol 3% with preservative-free sodium hyaluronate 0.1% eye drops in dry eye syndrome.

Methods: In total, 150 patients with dry eye syndrome were divided randomly into 3 groups. Group 1 (50 patients) was treated 4 times daily with preserved sodium hyaluronate 0.1%, group 2 (50 patients) was treated 4 times daily with diquafosol 3%, and group 3 (50 patients) was treated 4 times daily with diquafosol 3% and preservative-free sodium hyaluronate 0.1% eye drops for 3 months. Ocular surface disease index (OSDI) score, tear film break-up time, Schirmer I test, corneal fluorescein staining, and impression cytology were evaluated.

Results: There were significant improvements in the OSDI score, tear film break-up time, Schirmer I score, fluorescein and Rose Bengal staining, goblet cell density, and impression cytological findings in groups 2 and 3 compared with those for group 1 in patients with dry eye syndrome at 1, 2, and 3 months (P < 0.05). There were statistically significant improvements in the OSDI score (−8.48 ± 0.97, −5.69 ± 0.78; P = 0.02), fluorescein (−1.43 ± 0.21, −1.02 ± 0.18; P = 0.03), and Rose Bengal staining (−1.12 ± 0.26, −0.75 ± 0.12; P = 0.03), goblet cell density (89.65 ± 14.39, 70.36 ± 16.75; P = 0.03), and impression cytological findings (−0.53 ± 0.12, −0.34 ± 0.90; P = 0.01) in group 3 compared with those in group 2 at 3 months.

Conclusions: Treatment with diquafosol 3% with preservative-free sodium hyaluronate 0.1% was more effective than diquafosol 3% monotherapy or treatment with preserved sodium hyaluronate 0.1% in dry eye syndrome. Preservative-free sodium hyaluronate 0.1% eye drops can increase the effect of diquafosol 3% in dry eye syndrome.

*Department of Ophthalmology, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Gangwon-Do, Korea;

Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea; and

Institute of Clinical Medicine Research, Bucheon St. Mary's Hospital, Bucheon, Gyunggi-Do, Korea.

Reprints: Eun Chul Kim, MD, PhD, Department of Ophthalmology, Bucheon St Mary's Hospital, # 2 Sosa-Dong, Wonmi-Ku, Bucheon, Kyungki-Do 420-717, Korea (e-mail: eunchol@hanmail.net).

Supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (No. 2012R1A1A1038648) and the Institute of Clinical Medicine Research of Bucheon St Mary's Hospital, Research Fund, BCMC13LH03.

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

Received May 27, 2014

Accepted June 18, 2014

© 2014 by Lippincott Williams & Wilkins.