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Ballesteros-Sánchez A, De-Hita-Cantalejo C, Sánchez-González MC, Jansone-Langine Z, de Sotomayor MA, Culig J, Sánchez-González JM. Perfluorohexyloctane in dry eye disease: A systematic review of its efficacy and safety as a novel therapeutic agent. Ocul Surf 2023; 30:254-262. [PMID: 37813152 DOI: 10.1016/j.jtos.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/01/2023] [Accepted: 10/02/2023] [Indexed: 10/11/2023]
Abstract
Perfluorohexyloctane (F6H8), a physically and chemically inert synthetic compound, has recently emerged as a promising candidate for the treatment of DED due to its unique properties. A systematic review that only include full-length randomized controlled studies (RCTs), reporting the effects of F6H8 in three databases, PubMed, Scopus and Web of Science, was performed according to the PRISMA statement. The search period was performed between June 1, 2023, and June 21, 2023. The Cochrane risk of bias tool was used to analyze the quality of the studies selected. A total of six RCTs were included in this systematic review. F6H8 tear substitutes treatment achieved a higher improvement than control group interventions in most of the reported variables. The mean differences between both groups were in favor of F6H8 and were as follow: eye dryness score (EDS) base on a visual analogue scale (VAS) of -6.12 ± 4.3 points, ocular surface disease index (OSDI) questionnaire score of -2.8 ± 2.3 points, lipid layer thickness (LLT) of 11.4 ± 10.4 μm, total corneal fluorescein staining (tCFS) of -0.8 ± 0.3 points and ocular treatment-emergent adverse events (TEAEs) of -0.66 ± 1.7. Tear film break-up time (TBUT) was the only variable in favor of control group with a mean of -0.5 ± 0.4 s. Patient satisfaction after F6H8 tear substitutes treatment was high. Therefore, F6H8 tear substitutes improve dry eye symptoms and signs with a satisfactory tolerability and could be recommended in patients with DED.
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Affiliation(s)
- Antonio Ballesteros-Sánchez
- Department of Physics of Condensed Matter, Optics Area, University of Seville, 41012 Seville, Spain; Department of Ophthalmology, Clínica Novovision, 30008 Murcia, Spain.
| | | | | | - Zane Jansone-Langine
- University of Latvia, Jelgavas Street 1, Riga, Latvia; The Dr. Solomatin Eye Center, Marijas Street 2, Riga, Latvia
| | | | - Josip Culig
- Department of Medicine and Clinical Pharmacology, University of Applied Health Sciences, Zagreb, Croatia
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The efficacy of ocular surface assessment approaches in evaluating dry eye treatment with artificial tears. Sci Rep 2022; 12:21835. [PMID: 36528723 PMCID: PMC9759550 DOI: 10.1038/s41598-022-26327-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
This study evaluates the effectiveness of objective techniques in assessing dry eye disease (DED) treatment compared with the subjective assessment commonly used in clinical practice. Thirty subjects were recruited for two visits separated by 28(± 3) days of treatment with artificial tears. A buttery of common subjective assessment methods were accompanied by a set of objective techniques including measurement of noninvasive tear film break-up time (NIBUT), lipid layer thickness (LLT), and quantitative evaluation of tear film surface quality and dynamics (TFD). Additionally, meibography was performed. Two commercially available videokeratoscopes and a prototype of a lateral shearing interferometer were used for the measurements. Both subjective and objective techniques showed a positive effect of artificial tears in DED treatment. Statistically significant improvements were observed in subjective symptoms (from P < 0.001 for Ocular Surface Disease Index, OSDI to p = 0.019 for tearing), conjunctival redness (P = 0.022), ocular staining (P = 0.012), fluorescein tear film break-up time (P = 0.015), NIBUT (P = 0.037), LLT (P < 0.001), and TFD (P = 0.048). In general, weak or statistically insignificant correlations were observed between subjective and objective assessment methods. The apparent lack of correlation between these methods might indicate the complementary character of objective techniques that likely assess other characteristics of ocular surface health than those assessed subjectively.
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Hynnekleiv L, Magno M, Vernhardsdottir RR, Moschowits E, Tønseth KA, Dartt DA, Vehof J, Utheim TP. Hyaluronic acid in the treatment of dry eye disease. Acta Ophthalmol 2022; 100:844-860. [PMID: 35514082 PMCID: PMC9790727 DOI: 10.1111/aos.15159] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/05/2022] [Accepted: 04/18/2022] [Indexed: 12/31/2022]
Abstract
Dry eye disease (DED) is a highly prevalent and debilitating condition affecting several hundred million people worldwide. Hyaluronic acid (HA) is a naturally occurring glycosaminoglycan commonly used in the treatment of DED. This review aims to critically evaluate the literature on the safety and efficacy of artificial tears containing HA used in DED treatment. Literature searches were conducted in PubMed, including MEDLINE, and in Embase via Ovid with the search term: "(hyaluronic acid OR hyaluronan OR hyaluronate) AND (dry eye OR sicca)". A total of 53 clinical trials are included in this review, including eight placebo-controlled trials. Hyaluronic acid concentrations ranged from 0.1% to 0.4%. Studies lasted up to 3 months. A broad spectrum of DED types and severities was represented in the reviewed literature. No major complications or adverse events were reported. Artificial tears containing 0.1% to 0.4% HA were effective at improving both signs and symptoms of DED. Two major gaps in the literature have been identified: 1. no study investigated the ideal drop frequency for HA-containing eyedrops, and 2. insufficient evidence was presented to recommend any specific HA formulation over another. Future investigations assessing the optimal drop frequency for different concentrations and molecular weights of HA, different drop formulations, including tonicity, and accounting for DED severity and aetiology are essential for an evidence-based, individualized approach to DED treatment.
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Affiliation(s)
- Leif Hynnekleiv
- Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Department of OphthalmologyHaukeland University HospitalBergenNorway,Department of Twin Research & Genetic EpidemiologyKing's College LondonSt Thomas' HospitalLondonUK
| | - Morten Magno
- Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Department of Medical BiochemistryOslo University HospitalOsloNorway,Department of Ophthalmology and EpidemiologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands,Faculty of MedicineInstitute of Clinical MedicineUniversity of OsloOsloNorway
| | | | - Emily Moschowits
- Department of Medical BiochemistryOslo University HospitalOsloNorway
| | - Kim Alexander Tønseth
- Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Faculty of MedicineInstitute of Clinical MedicineUniversity of OsloOsloNorway
| | - Darlene A. Dartt
- Schepens Eye Research Institute/Massachusetts Eye and EarDepartment of OphthalmologyHarvard Medical SchoolBostonMassachusettsUSA
| | - Jelle Vehof
- Department of Twin Research & Genetic EpidemiologyKing's College LondonSt Thomas' HospitalLondonUK,Department of Ophthalmology and EpidemiologyUniversity Medical Center GroningenUniversity of GroningenGroningenThe Netherlands,Department of OphthalmologyVestfold Hospital TrustTønsbergNorway
| | - Tor P. Utheim
- Department of Plastic and Reconstructive SurgeryOslo University HospitalOsloNorway,Department of Medical BiochemistryOslo University HospitalOsloNorway,Department of OphthalmologySørlandet Hospital ArendalArendalNorway,Department of OphthalmologyStavanger University HospitalOsloNorway,Department of OphthalmologyVestre Viken HospitalDrammenNorway
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Li EG, Morenko EO, Zhavoronok ES, Panov AV, Kedik SA. Effect of the Molecular Mass of Hyaluronan on Its Thermophysical Properties and on Dynamic Viscosity of Its Aqueous Solutions. POLYMER SCIENCE SERIES A 2022. [DOI: 10.1134/s0965545x22700249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Contreras-Salinas H, Barajas-Hernández M, Baiza-Durán LM, Orozco-Ceja V, Rodríguez-Herrera LY. Ophthalmic Solution Safety Profile: Active Surveillance of a Sodium Hyaluronate/Chondroitin Sulfate Combination in Peruvian Population. Drug Healthc Patient Saf 2021; 13:117-123. [PMID: 34079383 PMCID: PMC8166348 DOI: 10.2147/dhps.s311817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/03/2021] [Indexed: 12/31/2022] Open
Abstract
Background Sodium hyaluronate/chondroitin sulfate fixed combination plays an essential role in the treatment of keratoconjunctivitis sicca, a multifactorial disease accompanied by ocular symptoms like alteration of the tear film. Despite low or no absorption of such drugs, these can cause secondary effects. An essential tool in the study of medication behavior is active pharmacovigilance. Unlike spontaneous reporting pharmacovigilance, this tool allows an appraisal of adverse drug reactions (ADRs)’ real incidence, a higher capacity to identify safety signals, the relationship with concomitant drugs and pathologies prevalent in the study population. This study aimed to evaluate the safety profile and identify and/or assess adverse reactions in an uncontrolled population. Methods Active pharmacovigilance by Drug Event Monitoring was performed. A total of 3 follow-up calls were made for 30 days for the identification of the ADRs, tolerability (ADR severity, seriousness, long term sequelae, and duration) and the possible risks (safety signals, medical interactions) of sodium hyaluronate and chondroitin sulfate (HUM). Results Thirty-five ADRs were identified in the 212 patients included in the study (0.17 ADR/patient). The 35 ADRs were classified into 3 System Organ Class (SOC) groups: general disorders and administration site conditions (74.2%), eye disorders (22.9%), and nervous system disorders (2.9%); and 4 Preferred Term (PT) groups: burning sensation (74.2%), followed by blurred vision (20%), ocular pain (2.9%) and headache (2.9%). All the ADRs were categorized as mild and not serious. No statistically significant differences were found in concomitantly medications, posology and age groups. Conclusion Good tolerability to the solution was identified, with a low incidence of ADRs. Just the same, all the associated ADRs were consistent with the information found in HUM’s physicochemical profile and the physiopathology of DED. No unknown risks were identified, reinforcing HUM’s safety profile.
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Affiliation(s)
| | | | | | - Vanessa Orozco-Ceja
- Pharmacovigilance Department, Laboratorios Sophia, S.A. de C.V., Guadalajara, Jalisco, Mexico
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Snetkov P, Zakharova K, Morozkina S, Olekhnovich R, Uspenskaya M. Hyaluronic Acid: The Influence of Molecular Weight on Structural, Physical, Physico-Chemical, and Degradable Properties of Biopolymer. Polymers (Basel) 2020; 12:E1800. [PMID: 32796708 PMCID: PMC7464276 DOI: 10.3390/polym12081800] [Citation(s) in RCA: 166] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 07/25/2020] [Accepted: 08/07/2020] [Indexed: 02/07/2023] Open
Abstract
Hyaluronic acid, as a natural linear polysaccharide, has attracted researchers' attention from its initial detection and isolation from tissues in 1934 until the present day. Due to biocompatibility and a high biodegradation of hyaluronic acid, it finds wide application in bioengineering and biomedicine: from biorevitalizing skin cosmetics and endoprostheses of joint fluid to polymeric scaffolds and wound dressings. However, the main properties of aqueous polysaccharide solutions with different molecular weights are different. Moreover, the therapeutic effect of hyaluronic acid-based preparations directly depends on the molecular weight of the biopolymer. The present review collects the information about relations between the molecular weight of hyaluronic acid and its original properties. Particular emphasis is placed on the structural, physical and physico-chemical properties of hyaluronic acid in water solutions, as well as their degradability.
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Affiliation(s)
- Petr Snetkov
- Institute BioEngineering, ITMO University, Kronverkskiy Prospekt, 49A, 197101 St. Petersburg, Russia; (K.Z.); (S.M.); (R.O.); (M.U.)
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Short-Term Results of Trial of Topical Insulin for Treatment of Dry Eyes in Diabetics. Eye Contact Lens 2020; 46 Suppl 1:S25-S32. [DOI: 10.1097/icl.0000000000000623] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
The study aimed to investigate the effects of silk fibroin in a mouse model of dry eye. The experimental dry eye mouse model was developed using more than twelve-weeks-old NOD.B10.H2b mice exposing them to 30–40% ambient humidity and injecting them with scopolamine hydrobromide for 10 days. Tear production and corneal irregularity score were measured by the instillation of phosphate buffered saline or silk fibroin. Corneal detachment and conjunctival goblet cell density were observed by hematoxylin and eosin or periodic acid Schiff staining in the cornea or conjunctiva. The expression of inflammatory markers was detected by immunohistochemistry in the lacrimal gland. The silk group tear production was increased, and corneal smoothness was improved. The corneal epithelial cells and conjunctival goblet cells were recovered in the silk groups. The expression of inflammatory factors was inhibited in the lacrimal gland of the silk group. These results show that silk fibroin improved the cornea, conjunctiva, and lacrimal gland in the mouse model of dry eye. These findings suggest that silk fibroin has anti-inflammatory effects in the experimental models of dry eye.
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Pérez-Balbuena AL, Ochoa-Tabares JC, Belalcazar-Rey S, Urzúa-Salinas C, Saucedo-Rodríguez LR, Velasco-Ramos R, Suárez-Sánchez RG, Rodríguez-Carrizalez AD, Oregón-Miranda AA. Efficacy of a fixed combination of 0.09 % xanthan gum/0.1 % chondroitin sulfate preservative free vs polyethylene glycol/propylene glycol in subjects with dry eye disease: a multicenter randomized controlled trial. BMC Ophthalmol 2016; 16:164. [PMID: 27645318 PMCID: PMC5028962 DOI: 10.1186/s12886-016-0343-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 06/16/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Dry eye disease (DED) is multifactorial, affecting 5-34 % of the global adult population and reducing quality of life. The artificial tears or lubricants are the therapy most used for the treatment of DED, due to their low side effect profile, which attempt to modify the properties of the tear film. The aim of the present study was to evaluate the clinical efficacy of a fixed combination of xanthan gum and chondroitin sulfate preservative free on the ocular surface of patients with dry eye disease during 60 days of intervention. METHODS A phase III, double-blind, masked, controlled, multicenter, clinical trial of 148 subjects, randomized to either a fixed combination of xanthan gum 0.09 % and chondroitin sulfate 0.1 % (XG/CS) ophthalmic solution (n = 76) or a fixed combination of polyethylene glycol 400 0.4 % and propylene glycol 0.3 % (PEG/PG) (n = 72). Subjects self-dosed four times daily during 60 days. Follow-up was set on days 2, 7, 15, 30 and 60. Assessments of anterior/posterior segment ocular signs were performed. The outcome measures included Schirmer test, tear film break-up time and OSDI score. Security variables included intraocular pressure, lisamine green and fluorescein ocular surface stains. RESULTS The primary efficacy endpoints were similar between groups at baseline. After intervention time Schirmer test increased in both groups compared to baseline, XG/CS (6.4 ± 2.2 vs 11.0 ± 6.6; p = 0.002) and PEG/PG (6.5 ± 2.5 vs 10.5 ± 5.6; p = 0.019) respectively. Similar results were reported in the tear film break-up time in XG/CS (5.5 ± 2.1 vs 7.4 ± 2.9; p = 0.027) and PEG/PG (5.2 ± 2.0 vs 7.4 ± 2.7; p = 0.046) respectively. The OSDI score decreased to normal values in both groups, XG/CS (19.3 ± 7.4 vs 7.3 ± 5.9; p = 0.001) and PEG/PG (19.3 ± 7.5 vs 7.9 ± 8.2; p = 0.001) respectively. There was no significant difference between treatments for any parameter. Moreover, both groups decreased the presence of burning sensation, tearing, foreign body sensation, conjunctival hyperemia and photophobia. The adverse events were not related to the interventions. CONCLUSIONS Xanthan gum/chondroitin sulfate preservative free showed similar clinical efficacy, evaluated with OSDI score, TBUT and Schirmer test compared to polyethylene glycol/propylene glycol in the treatment of dry eye disease. TRIAL REGISTRATION ClinicalTrials.gov: NCT01657253 . Date of registration May 19, 2014.
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Affiliation(s)
- Ana L. Pérez-Balbuena
- Department of anterior segment, Asociación para evitar la ceguera en México, Hospital Dr. Luis Sánchez Bulnes, IAP, Ciudad de México, Mexico
| | | | | | | | - Laura R. Saucedo-Rodríguez
- Department of anterior segment, Antiguo Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco Mexico
| | - Regina Velasco-Ramos
- Department of anterior segment, Fundación Hospital Nuestra Señora de la Luz. IAP, Ciudad de México, Mexico
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Arbeitsablauf zur Behandlung des Trockenen Auges, ein Versuch der Zuordnung von Diagnose zur Therapie. SPEKTRUM DER AUGENHEILKUNDE 2016. [DOI: 10.1007/s00717-016-0296-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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11
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Torrent-Burgués J. Langmuir films study on lipid-containing artificial tears. Colloids Surf B Biointerfaces 2016; 140:185-188. [DOI: 10.1016/j.colsurfb.2015.12.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 11/27/2015] [Accepted: 12/18/2015] [Indexed: 12/18/2022]
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Contreras-Rubio AY, Baiza-Durán L, Olvera-Montaño O, Miranda-Robles M, Bonilla-García J, Mercado-Sesma A. Histopathological changes on the ocular surface of New Zealand white rabbits after instillation of a fixed combination of 0.09 % xanthan gum and 0.1 % chondroitin sulfate. Int Ophthalmol 2016; 36:841-844. [DOI: 10.1007/s10792-016-0192-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 01/28/2016] [Indexed: 01/25/2023]
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Alves M, Fonseca EC, Alves MF, Malki LT, Arruda GV, Reinach PS, Rocha EM. Dry eye disease treatment: a systematic review of published trials and a critical appraisal of therapeutic strategies. Ocul Surf 2013; 11:181-92. [PMID: 23838019 DOI: 10.1016/j.jtos.2013.02.002] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 01/15/2013] [Accepted: 02/01/2013] [Indexed: 12/15/2022]
Abstract
Dry eye disease (DED) treatment is an area of increasing complexity, with the emergence of several new treatment agents in recent years. Evaluation of the efficacy of these agents is limited by heterogeneity in outcomes definition and the small number of comparative studies. We provide a systematic review of clinical trials (CTs) related to DED treatment and a critical appraisal of CT public databases. CT reports obtained from eight databases were reviewed, as well as public free-access electronic databases for CT registration. Data evaluation was based on endpoints such as symptoms, Schirmer test, ocular surface staining scores, recruitment of patients, type and efficacy of the drug, and the design and site of performance of the study. Forty-nine CTs were evaluated involving 5,189 patients receiving DED treatment. Heterogeneity in study design prevented meta-analysis from yielding meaningful results, and a descriptive analysis of these studies was conducted. The most frequent categories of drugs for DED in these studies were artificial tears, followed by anti-inflammatory drugs and secretagogues. Although 116 studies have been completed, according to the registration database for clinical trials, only 17 of them (15.5%) were published. Out of 185 registered CTs related to DED, 72% were performed in the USA. The pharmaceutical industry sponsored 78% of them. The identification of effective DED treatment strategies is hindered by the lack of an accepted set of definitive criteria for evaluating disease severity.
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Affiliation(s)
- Monica Alves
- Department of Ophthalmology, Otorrinolaringology and Head & Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
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Shigeyasu C, Hirano S, Akune Y, Mochizuki H, Yamada M. Evaluation of the Frequency of Ophthalmic Solution Application: Washout Effects of Topical Saline Application on Tear Components. Curr Eye Res 2013; 38:722-8. [DOI: 10.3109/02713683.2013.777967] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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15
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Effect of Humidity Variations in a Controlled Environment Chamber on Tear Evaporation After Dry Eye Therapy. Eye Contact Lens 2013; 39:169-74. [DOI: 10.1097/icl.0b013e318283dfc6] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Tomlinson A, Madden LC, Simmons PA. Effectiveness of dry eye therapy under conditions of environmental stress. Curr Eye Res 2013; 38:229-36. [PMID: 23294168 PMCID: PMC3585441 DOI: 10.3109/02713683.2012.757323] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose: Dry eye is often characterized by increased tear evaporation due to poor tear film quality, especially of the lipid component of the tear film. Using an environmental chamber to induce environmental stress, this study compared the effect of three lubricant eye drops on various aspects of tear physiology in a crossover design (evaporation was the principal outcome measure). Methods: Three eye drop formulas were tested: 0.5% carmellose sodium (Drop C), 0.5% carmellose sodium with added lipid (Drop C-L) and 1.0% glycerine with added lipid (Drop G-L). Nineteen control and 18 dry eye subjects used each product for 2 weeks, three times per day, in a random order, with a minimum 1-week washout between treatment periods. Tear evaporation, break up time, osmolarity, tear structure (by interferometry) and patient symptoms were assessed with the subjects adapted for 10 min in an environmental chamber controlled at 20% relative humidity and 22 °C. The treatment effects were analyzed using general linear model repeated measures analyses of variance. Results: In dry eye subjects, evaporation, break up time, osmolarity and symptoms improved for all formulas (p < 0.05). Normal subjects showed some improvements: evaporation with C-L, osmolarity with C and symptoms with C-L and G-L. Change in evaporation was greater for both C-L and G-L versus C (p < 0.05), and there was a trend for C-L to reduce evaporation more than G-L (p < 0.11). There were no significant treatment effects on tear film structure. Conclusion: Overall, the eye drop formula containing both carmellose sodium and lipid (C-L) produced a greater treatment effect on tear evaporation than the other formulations containing only one of these ingredients. This study also demonstrates the utility of a controlled environmental chamber in showing the difference in performance between dry eye treatments.
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Affiliation(s)
- Alan Tomlinson
- Vision Sciences, Glasgow Caledonian University, Glasgow, UK.
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Weeks A, Morrison D, Alauzun JG, Brook MA, Jones L, Sheardown H. Photocrosslinkable hyaluronic acid as an internal wetting agent in model conventional and silicone hydrogel contact lenses. J Biomed Mater Res A 2012; 100:1972-82. [PMID: 22566397 DOI: 10.1002/jbm.a.33269] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 04/27/2011] [Indexed: 11/06/2022]
Abstract
Photocrosslinkable methacrylated hyaluronic acid (HA) was prepared and incorporated into model conventional and silicone hydrogel contact lenses as an internal wetting agent. The molecular weight of the HA, the degree of methacrylation as well as the amount (0.25 to 1.0 wt %) incorporated were varied. The HA-containing hydrogels were analyzed using a variety of techniques including water contact angles, equilibrium water content (EWC), and lysozyme sorption. The presence of HA could be detected in the materials using X-ray photoelectron spectroscopy and Fourier transform infrared spectroscopy-attenuated total reflectance. The materials containing methacrylated HA had improved hydrophilicity and reduced lysozyme sorption. Effects of modified HA on EWC were dependent upon the materials but generally increased water uptake. Increased mobility of the HA associated with a lower molecular weight and lower degree of methacrylation was found to be more effective in improving hydrophilicity and decreasing lysozyme sorption than the less mobile HA. All results found suggest that photocrosslinkable HA has significant potential in contact lens applications.
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Affiliation(s)
- Andrea Weeks
- School of Biomedical Engineering, McMaster University, 1280 Main St. West, Hamilton, Ontario
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Manetti C, Casciani L, Pescosolido N. LF-NMR water self-diffusion and relaxation time measurements of hydrogel contact lenses interacting with artificial tears. JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION 2012; 15:331-42. [PMID: 15147165 DOI: 10.1163/156856204322977210] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The different swelling properties of ionic and non-ionic lenses, immersed in sodium chloride or artificial tears, were investigated by Low-Field Nuclear Magnetic Resonance (LF-NMR) through relaxation time and self-diffusion coefficient measurements. A new model was developed to estimate the water self-diffusion coefficient inside the lenses, the results of which revealed a different mechanism of interaction for ionic versus non-ionic materials with artificial tears. The consequence of this finding suggests clinical implications.
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Affiliation(s)
- Cesare Manetti
- Dipartimento di Chimica, Università di Roma La Sapienza, Piazzale A. Moro 5, 00185 Rome, Italy.
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Weeks A, Luensmann D, Boone A, Jones L, Sheardown H. Hyaluronic acid as an internal wetting agent in model DMAA/TRIS contact lenses. J Biomater Appl 2011; 27:423-32. [DOI: 10.1177/0885328211410999] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Model silicone hydrogel contact lenses, comprised of N,N-dimethylacrylamide and methacryloxypropyltris (trimethylsiloxy) silane, were fabricated and hyaluronic acid (HA) was incorporated as an internal wetting agent using a dendrimer-based method. HA and dendrimers were loaded into the silicone hydrogels and cross-linked using 1-ethyl-3-(3-dimethylaminopropyl)-carbodiimide chemistry. The presence and location of HA in the hydrogels was confirmed using X-ray photoelectron spectroscopy and confocal laser scanning microscopy, respectively. The effects of the presence of HA on the silicone hydrogels on hydrophilicity, swelling behavior, transparency, and lysozyme sorption and denaturation were evaluated. The results showed that HA increased the hydrophilicity and the equilibrium water content of the hydrogels without affecting transparency. HA also significantly decreased the amount of lysozyme sorption ( p < 0.002). HA had no effect on lysozyme denaturation in hydrogels containing 0% and 1.7% methacrylic acid (MAA) (by weight) but when the amount of MAA was increased to 5%, the level of lysozyme denaturation was significantly lower compared to control materials. These results suggest that HA has great potential to be used as a wetting agent in silicone hydrogel contact lenses to improve wettability and to decrease lysozyme sorption and denaturation.
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Affiliation(s)
- Andrea Weeks
- School of Biomedical Engineering, McMaster University, Hamilton ON Canada
| | | | - Adrienne Boone
- School of Optometry, University of Waterloo, Waterloo ON Canada
| | - Lyndon Jones
- School of Biomedical Engineering, McMaster University, Hamilton ON Canada
- School of Optometry, University of Waterloo, Waterloo ON Canada
- Department of Chemical Engineering, McMaster University, Hamilton ON Canada
| | - Heather Sheardown
- School of Biomedical Engineering, McMaster University, Hamilton ON Canada
- School of Optometry, University of Waterloo, Waterloo ON Canada
- Department of Chemical Engineering, McMaster University, Hamilton ON Canada
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Uhart M, Pirot F, Boillon A, Senaux E, Tall L, Diouf E, Burillon C, Padois K, Falson F, Leboucher G, Pivot C. Assessment of sodium hyaluronate gel as vehicle for intracameral delivery of cefuroxime in endophthalmitis prophylaxis. Int J Pharm 2010; 398:14-20. [DOI: 10.1016/j.ijpharm.2010.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Revised: 07/02/2010] [Accepted: 07/07/2010] [Indexed: 10/19/2022]
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Abstract
PURPOSE To determine the effect of two artificial tears of different viscosities in the relief of environmental dry eye induced with a novel tear stress test (TST). METHODS A novel TST was developed and validated. The following four test conditions were evaluated in 12 healthy normal subjects in a cross-over and subject masked study; unprotected (no test solution used), relief (test solution instilled just after application of TST), immediate protection (test solution instilled just before application of TST), and chronic protection (1 week prophylactic use of the solution). The test solutions were Cellumed, with high viscosity, and Refresh Contacts, with low viscosity. Low contrast visual acuity, symptoms with analogue scales (symptom scoring), non-invasive tear break-up time, and tear evaporation were measured before (prestress) and 2 min after (poststress) application of TST. Two weeks of washout period was allowed after first test solution. RESULTS In unprotected test condition, there was no significant difference between pre- and poststress visual acuity (p = 0.102), tear evaporation (p = 0.530), and non-invasive tear break-up time (p = 0.878), however, poststress total symptom score was significantly higher than prestress (p = 0.002). No significant differences were seen between pre- and post-total symptom score at relief (p = 0.241 for Cellumed and 0.114 for Refresh Contacts) and immediate protection (p = 0.890 for Cellumed and 0.136 for Refresh Contacts) for both test solutions, whereas postsymptoms total score was significantly higher than prestress at chronic protection (p = 0.003 for both). No significant differences were seen in the effect of the two solutions in all test conditions. CONCLUSIONS There is an increase in dry eye symptomatology after ocular stress. The use of artificial tears just before or after ocular stress is helpful in relieving resultant symptoms in normals.
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Moon JW, Lee HJ, Shin KC, Wee WR, Lee JH, Kim MK. Short term effects of topical cyclosporine and viscoelastic on the ocular surfaces in patients with dry eye. KOREAN JOURNAL OF OPHTHALMOLOGY 2008; 21:189-94. [PMID: 18063881 PMCID: PMC2629882 DOI: 10.3341/kjo.2007.21.4.189] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the short term effects of topical 0.05% cyclosporine (CsA) and a mixture of 0.08% chondroitin sulfate and 0.06% sodium hyaluronate (CS-HA) on dry eye ocular surfaces. Methods 36 patients with moderate to severe dry eye (5 mm/5 min or less with Schirmer's test or tear break up time (BUT) less than 6 seconds), were treated with topical application of CS-HA on one eye and CsA on the other 4 times a day for 6-8 weeks. BUT, Schirmer's test without anesthesia, and conjunctival impression cytology (CIC; goblet cell density, nucleus to cytoplasmic ratio, and epithelial cell morphology) were evaluated and compared between eyes before and after treatment (repeated measurement of ANOVA). Results After treatment, BUT and tear wettings were significantly prolonged in each group. Topical CsA treated eyes had greater increase in BUT (p=0.026); there was no significant difference in tear wetting (p=0.132). While the 3 parameters of CIC improved in both groups, goblet cell density was significantly higher in eyes treated with CsA (p=0.033). Conclusions While both CS-HA and 0.05% CsA eyedrops improve ocular surfaces, topical CsA may have a better effect on enhancing tear film stability and goblet cell density.
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Affiliation(s)
- Jun Woong Moon
- Department of Ophthalmology, Konkuk University Hospital, Seoul, Korea
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Kadyan A, Ilango B. Re: "instant vision" compared with postoperative patching: clinical evaluation and patient satisfaction after bilateral cataract surgery. Am J Ophthalmol 2007; 144:336-7; author reply 337. [PMID: 17659987 DOI: 10.1016/j.ajo.2007.04.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2007] [Accepted: 04/19/2007] [Indexed: 11/25/2022]
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Ribeiro W, Mata JL, Saramago B. Effect of concentration and temperature on surface tension of sodium hyaluronate saline solutions. LANGMUIR : THE ACS JOURNAL OF SURFACES AND COLLOIDS 2007; 23:7014-7. [PMID: 17506586 DOI: 10.1021/la700269k] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
The effect of concentration and temperature on the surface tension of sodium hyaluronate (NaHA) saline solutions was investigated using the technique of the shape of pendant drops. The decay rate of the surface tension with the increase of NaHA concentration was well-described by the empirical Hua-Rosen equation. Adsorption at the air-liquid interface was estimated using the Gibbs equation. The temperature dependence of a dilute solution and a semidilute entangled solution was numerically fitted with a second-order polynomial equation. The surface behavior of the NaHA saline solutions was interpreted in terms of their known viscoelastic properties.
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Affiliation(s)
- Walkiria Ribeiro
- Centro de Química Estrutural, Complexo I, Instituto Superior Técnico, T U Lisbon, Avenida Rovisco Pais, 1049-001 Lisbon, Portugal
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Choy EPY, Cho P, Benzie IFF, Choy CKM. 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 2006; 25:1200-4. [PMID: 17172898 DOI: 10.1097/01.ico.0000243960.14651.95] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To use a novel porcine dry eye model (pDEM) to study the effect of various artificial tears on corneal abrasion and epithelial cell death under severe "dry eye" conditions. METHODS A 60-second lacrimation-blink interval, which simulates a severe dry eye condition, was set up with our novel pDEM. The corneal protective effect of lubricating the eye for 4 hours with Dulbecco phosphate-buffered saline (DPBS, as control; n = 20) and with 3 types of commercially available artificial tears (n = 17 for each) that contained different lubricating agents was studied. Effect was determined in terms of the change in fluorescein staining grade (on a 0-4 point scale with 0.5 increments) of the cornea and the number of dead cells (by trypan blue staining) on the corneal surface. RESULTS Median increase in fluorescein grading (median) in corneas treated for 4 hours with artificial tears containing sodium hyaluronate or hydroxypropyl methylcellulose was significantly (P < 0.002) smaller than with artificial tears containing balanced saline with an unknown demulcent or the DPBS control. The numbers of dead epithelial cells in the central corneas lubricated with artificial tears containing sodium hyaluronate or hydroxypropyl methylcellulose (229 +/- 71 and 221 +/- 65 [SD], respectively) were also significantly (P < 0.005) smaller than those in the corneas of eyes lubricated with artificial tears containing balanced saline with an unknown demulcent or DPBS alone (328 +/- 106 and 341 +/- 113, respectively). CONCLUSION Results show that artificial tears containing sodium hyaluronate or hydroxypropyl methylcellulose as lubricating agents give enhanced corneal protection against desiccation and show the use of this novel pDEM model in evaluating corneal protection from desiccation.
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Affiliation(s)
- Emily Pik Yin Choy
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Johnson ME, Murphy PJ, Boulton M. Effectiveness of sodium hyaluronate eyedrops in the treatment of dry eye. Graefes Arch Clin Exp Ophthalmol 2005; 244:109-12. [PMID: 15983814 DOI: 10.1007/s00417-005-0028-1] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2005] [Accepted: 05/21/2005] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Dry eye is a common condition, affecting approximately 10-20% of the adult population. Artificial tears are often effective in relieving symptoms in mild and moderate dry eye by replenishing deficient tear volume. Sodium hyaluronate has been proposed as a component in artificial tears, due to its viscoelastic rheology. This paper reports on a study carried out to assess the efficacy of two recently developed eyedrops containing 0.1% and 0.3% sodium hyaluronate (SH) in the treatment of moderate dry eye. METHODS Thirteen subjects were recruited with moderate dry eye. Forty microlitres of 0.1% SH, 0.3% SH, or 0.9% saline were instilled in both eyes, and the subjects' symptom intensity and non-invasive break-up time (NIBUT) were measured at 5, 15, 30, 45, and 60 min, and then hourly, until 6 h after drop instillation. This was repeated twice following an interval of 7(+/-1) days, but with a different treatment so that at the end of the final visit each subject had trialled all products. Drop allocation was randomized and double-masked. RESULTS Both symptoms and NIBUT improved with all treatments. These changes were of a larger magnitude and longer duration with the SH containing eyedrops than with saline. SH of 0.3% tended to perform better than 0.1% SH and achieved statistical significance (P=0.04) for NIBUT when considered over the whole 6-h study period. CONCLUSIONS Sodium hyaluronate of 0.1% and 0.3% reduces symptoms of ocular irritation and lengthens NIBUT in subjects with moderate dry eye more effectively than saline, in terms of peak effect and duration of action.
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Affiliation(s)
- Michael E Johnson
- Contact Lens and Anterior Eye Research Group, School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
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