Skip to main content
SpringerLink
Log in

Tear film stability in patients with symptoms of dry eye after instillation of dual polymer hydroxypropyl guar/sodium hyaluronate vs single polymer sodium hyaluronate

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

This study evaluated the tear film stability in patients with symptoms of dry eye after installation of dual polymer hydroxypropyl guar/sodium hyaluronate (DPHG/SH) vs single polymer SH.

Methods

Patients with recently diagnosed mild to moderate dry eye disease (OSDI score 23–32 points) were included. For each patient, the right eye was randomized to receive DPHG/SH or 0.15% SH. Just after the administration of the drop to the right eye, the fellow eye received the other eye drop. The first non-invasive Keratograph first break-up time (NIKBUT), average NIKBUT and tear meniscus height (TMH) were measured before administration of the eye drops, at 1-min, 15 min, 30 min, 60 min, 90 min, and 120 min after instillation.

Results

A total of 29 patients aged 22.8 ± 2.2 years participated in the study (21 women). No differences between the eye receiving DPHG/SH and single polymer SH were observed for the first NIKBUT (p = 0.45) and average NIKBUT (p = 0.24) variables at any time point. Both DPHG/SH and single polymer SH increased the TMH (p of time effect < 0.001), but with no difference between groups (p = 0.95).

Conclusion

Both DPHG/SH and single polymer SH solutions provide lubrication of the eye surface, however, with no difference in NIKBUT and TMH evaluations for up to two hours following administration.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gayton JL (2009) Etiology, prevalence, and treatment of dry eye disease. Clin Ophthalmol 3:405–412

    Article  PubMed  PubMed Central  Google Scholar 

  2. Lin H, Yiu SC (2014) Dry eye disease: a review of diagnostic approaches and treatments. Saudi J Ophthalmol 28:173–181

    Article  PubMed  PubMed Central  Google Scholar 

  3. Yavuz B, Bozdağ Pehlivan S, Unlü N (2012) An overview on dry eye treatment: approaches for cyclosporin a delivery. Sci World J 2012:194848

    Article  Google Scholar 

  4. de Paiva CS (2017) Effects of aging in dry eye. Int Ophthalmol Clin 57:47–64

    Article  PubMed  PubMed Central  Google Scholar 

  5. Noor NA, Rahayu T, Gondhowiardjo TD (2020) Prevalence of dry eye and its subtypes in an elderly population with cataracts in Indonesia. Clin Ophthalmol 14:2143–2150

    Article  PubMed  PubMed Central  Google Scholar 

  6. Semp DA, Beeson D, Sheppard AL et al (2023) Artificial tears: a systematic review. Clin Optom (Auckl) 15:9–27

    Article  PubMed  Google Scholar 

  7. Zhang X, Jeyalatha MV, Qu Y, He X, Ou S, Bu J, Jia C, Wang J, Wu H, Liu Z, Li W (2017) Dry eye management: targeting the ocular surface microenvironment. Int J Mol Sci. https://doi.org/10.3390/ijms18071398

    Article  PubMed  PubMed Central  Google Scholar 

  8. Johnson ME, Murphy PJ, Boulton M (2006) Effectiveness of sodium hyaluronate eyedrops in the treatment of dry eye. Graefes Arch Clin Exp Ophthalmol 244:109–112

    Article  CAS  PubMed  Google Scholar 

  9. You IC, Li Y, Jin R et al (2018) Comparison of 0.1%, 0.18%, and 0.3% hyaluronic acid eye drops in the treatment of experimental dry eye. J Ocul Pharmacol Ther 34:557–564

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Dick HB, Schwenn O (2012) Viscoelastics in ophthalmic surgery. Springer Science & Business Media, Berlin

    Google Scholar 

  11. Balazs EA, Denlinger JL (1989) Clinical uses of hyaluronan. Ciba Found Symp 143:265–75

    CAS  PubMed  Google Scholar 

  12. Choy EPY, Cho P, Benzie IFF, Choy CKM (2006) Investigation of corneal effect of different types of artificial tears in a simulated dry eye condition using a novel porcine dry eye model (pDEM). Cornea 25:1200–1204

    Article  PubMed  Google Scholar 

  13. Nakamura S, Okada S, Umeda Y, Saito F (2004) Development of a rabbit model of tear film instability and evaluation of viscosity of artificial tear preparations. Cornea 23:390–397

    Article  PubMed  Google Scholar 

  14. Oh HJ, Li Z, Park S-H, Yoon KC (2014) Effect of hypotonic 0.18% sodium hyaluronate eyedrops on inflammation of the ocular surface in experimental dry eye. J Ocul Pharmacol Ther 30:533–542

    Article  CAS  PubMed  Google Scholar 

  15. Aragona P, Papa V, Micali A et al (2002) Long term treatment with sodium hyaluronate-containing artificial tears reduces ocular surface damage in patients with dry eye. Br J Ophthalmol 86:181–184

    Article  PubMed  PubMed Central  Google Scholar 

  16. Lee HS, Ji YS, Yoon KC (2014) Efficacy of hypotonic 0.18% sodium hyaluronate eye drops in patients with dry eye disease. Cornea 33:946–951

    Article  PubMed  Google Scholar 

  17. Labetoulle M, Schmickler S, Galarreta D et al (2018) Efficacy and safety of dual-polymer hydroxypropyl guar- and hyaluronic acid-containing lubricant eyedrops for the management of dry-eye disease: a randomized double-masked clinical study. Clin Ophthalmol 12:2499–2508

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Wolffsohn JS, Arita R, Chalmers R et al (2017) TFOS DEWS II diagnostic methodology report. Ocul Surf 15:539–574

    Article  PubMed  Google Scholar 

  19. Mooi JK, Wang MTM, Lim J et al (2017) Minimising instilled volume reduces the impact of fluorescein on clinical measurements of tear film stability. Cont Lens Anterior Eye 40:170–174

    Article  PubMed  Google Scholar 

  20. Best N, Drury L, Wolffsohn JS (2012) Clinical evaluation of the oculus keratograph. Cont Lens Anterior Eye 35:171–174

    Article  CAS  PubMed  Google Scholar 

  21. Cox SM, Nichols KK, Nichols JJ (2015) Agreement between automated and traditional measures of tear film breakup. Optom Vis Sci 92:e257–e263

    Article  PubMed  PubMed Central  Google Scholar 

  22. Wang MTM, Craig JP (2018) Comparative evaluation of clinical methods of tear film stability assessment: a randomized crossover trial. JAMA Ophthalmol 136:291–294

    Article  PubMed  PubMed Central  Google Scholar 

  23. Abdelfattah NS, Dastiridou A, Sadda SR, Lee OL (2015) Noninvasive imaging of tear film dynamics in eyes with ocular surface disease. Cornea 34(Suppl 10):S48-52

    Article  PubMed  Google Scholar 

  24. Fuller DG, Potts K, Kim J (2013) Noninvasive tear breakup times and ocular surface disease. Optom Vis Sci 90:1086–1091

    Article  PubMed  Google Scholar 

  25. Doronin O, Maiboroda R (2015) GEE estimators in mixture model with varying concentrations. Acta Universitatis Lodziensis, Folia Oeconomica, p 3

    Google Scholar 

  26. Studio Team (2020) RStudio: integrated development for R. RStudio, PBC, Boston, MA. https://www.rstudio.com

  27. Wilkinson L (2011) ggplot2: elegant graphics for data analysis by WICKHAM, H. Biometrics 67:678–679

    Article  Google Scholar 

  28. Mohamed HB, Abd El-Hamid BN, Fathalla D, Fouad EA (2022) Current trends in pharmaceutical treatment of dry eye disease: a review. Eur J Pharm Sci 175:106206

    Article  CAS  PubMed  Google Scholar 

  29. Pucker AD, Ng SM, Nichols JJ (2016) Over the counter (OTC) artificial tear drops for dry eye syndrome. Cochrane Database Syst Rev 2:CD009729

    PubMed  Google Scholar 

  30. Aragona P, Giannaccare G, Mencucci R et al (2021) Modern approach to the treatment of dry eye, a complex multifactorial disease: a P.I.C.A.S.S.O. board review. Br J Ophthalmol 105:446–453

    Article  PubMed  Google Scholar 

  31. Che Arif FA, Hilmi MR, Mohd Kamal K, Ithnin MH (2020) Evaluation of 18 artificial tears based on viscosity and pH. MyJO 2:96–111

    Article  Google Scholar 

  32. Gagliano C, Papa V, Amato R et al (2018) Measurement of the retention time of different ophthalmic formulations with ultrahigh-resolution optical coherence tomography. Curr Eye Res 43:499–502

    Article  CAS  PubMed  Google Scholar 

  33. Paugh JR, Nguyen AL, Ketelson HA et al (2008) Precorneal residence time of artificial tears measured in dry eye subjects. Optom Vis Sci 85:725–731

    Article  PubMed  Google Scholar 

  34. Park Y, Song JS, Choi CY et al (2017) A randomized multicenter study comparing 0.1%, 0.15%, and 0.3% sodium hyaluronate with 0.05% cyclosporine in the treatment of dry eye. J Ocul Pharmacol Ther 33:66–72

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Troiano P, Monaco G (2008) Effect of hypotonic 0.4% hyaluronic acid drops in dry eye patients: a cross-over study. Cornea 27:1126–1130

    Article  PubMed  Google Scholar 

  36. Ishioka M, Kato N, Takano Y et al (2009) The quantitative detection of blurring of vision after eyedrop instillation using a functional visual acuity system. Acta Ophthalmol 87:574–575

    Article  PubMed  Google Scholar 

  37. Koh S, Maeda N, Ikeda C et al (2013) Effect of instillation of eyedrops for dry eye on optical quality. Invest Ophthalmol Vis Sci 54:4927–4933

    Article  PubMed  Google Scholar 

  38. Berger JS, Head KR, Salmon TO (2009) Comparison of two artificial tear formulations using aberrometry. Clin Exp Optom 92:206–211

    Article  PubMed  Google Scholar 

  39. Markoulli M, Sobbizadeh A, Tan J et al (2018) The effect of optive and optive advanced artificial tears on the healthy tear film. Curr Eye Res 43:588–594

    Article  CAS  PubMed  Google Scholar 

  40. Evangelista M, Koverech A, Messano M, Pescosolido N (2011) Comparison of three lubricant eye drop solutions in dry eye patients. Optom Vis Sci 88:1439–1444

    Article  PubMed  Google Scholar 

  41. Uchiyama E, Aronowicz JD, Butovich IA, McCulley JP (2007) Increased evaporative rates in laboratory testing conditions simulating airplane cabin relative humidity: an important factor for dry eye syndrome. Eye Contact Lens 33:174–176

    Article  PubMed  Google Scholar 

  42. Wojtowicz JC, Arciniega JC, McCulley JP, Mootha VV (2010) Effect of systane and optive on aqueous tear evaporation in patients with dry eye disease. Eye Contact Lens 36:358–360

    Article  PubMed  Google Scholar 

  43. Koh S, Ikeda C, Watanabe S et al (2015) Effect of non-invasive tear stability assessment on tear meniscus height. Acta Ophthalmol 93:e135–e139

    Article  PubMed  Google Scholar 

  44. Molina-Solana P, Domínguez-Serrano FD, Garrido-Hermosilla AM, Montero-Iruzubieta J, Fernández-Palacín A, Rodríguez-de-la-Rúa-Franch E, Caro-Magdaleno M (2020) Improved tear film stability in patients with dry eye after hyaluronic acid and galactoxyloglucan use. Clin Ophthalmol. 14:1153–1159

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Calvão-Santos G, Borges C, Nunes S et al (2011) Efficacy of 3 different artificial tears for the treatment of dry eye in frequent computer users and/or contact lens users. Eur J Ophthalmol 21:538–544

    Article  PubMed  Google Scholar 

  46. Guillon M, Maissa C, Ho S (2010) Evaluation of the effects on conjunctival tissues of optive eyedrops over one month usage. Cont Lens Anterior Eye 33:93–99

    Article  CAS  PubMed  Google Scholar 

  47. Wang MTM, Xue AL, Craig JP (2019) Screening utility of a rapid non-invasive dry eye assessment algorithm. Cont Lens Anterior Eye 42:497–501

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Prof. Maria Markoulli from the UNSW Dry Eye Clinic, School of Optometry and Vision Science, Sydney, Australia for critical comments on the manuscript.

Funding

The study has been supported by a grant from Alcon Laboratories No. #69446831.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Hygeia Clinic, ul. Jaśkowa Dolina 57, 80-286, Gdańsk, Poland

    Piotr Kanclerz, Natasza Bazylczyk & Szymon Adam Radomski

  2. Helsinki Retina Research Group, University of Helsinki, Helsinki, Finland

    Piotr Kanclerz

Authors
  1. Piotr Kanclerz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Natasza Bazylczyk
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Szymon Adam Radomski
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

PK and NB, wrote the main manuscript text, SR reviewed the text. All authors reviewed the manuscript.

Corresponding author

Correspondence to Piotr Kanclerz.

Ethics declarations

Conflict of interest

This study received financial support from an Alcon Investigator Initiated Grant (IIT #68879269). Dr. Kanclerz reports fees from Alcon, Carl Zeiss Meditec, and non-financial support from Optopol Technology and Visim. Ms. Bazylczyk has nothing to disclose. Dr. Radomski has nothing to disclose. The authors have neither proprietary nor commercial interests in any medications or materials discussed.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. The study protocol received approval from the Local Bioethical Committee (Komisja Bioetyczna Przy Izbie Lekarskiej w Gdańsku, approval no KB-33/22).

Informed consent

Informed consent to participate in the study was obtained from all participants.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kanclerz, P., Bazylczyk, N. & Radomski, S.A. Tear film stability in patients with symptoms of dry eye after instillation of dual polymer hydroxypropyl guar/sodium hyaluronate vs single polymer sodium hyaluronate. Int Ophthalmol 44, 193 (2024). https://doi.org/10.1007/s10792-024-03061-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10792-024-03061-5

Keywords

Search

Navigation