A randomized multicenter study comparing seawater washes and carmellose artificial tears eyedrops in the treatment of dry eye syndrome
Received 31 August 2018
Accepted for publication 10 January 2019
Published 12 March 2019 Volume 2019:13 Pages 483—490
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Manuel Diaz-Llopis,1–5 Maria Dolores Pinazo-Duran,2,3,6–9 Loreto Diaz-Guiñon,5 Miriam Rahhal-Ortuño,10 Mercedes Perez-Ramos,8,9 Rosabel Bosch,8,9 Roberto Gallego-Pinazo,11,12 Rosa Dolz-Marco,11,12 Teresa Diaz-Guiñon,5 María Diaz,1,5 Francisco Javier Romero,13 Angel Cisneros10
1University of Valencia, Valencia, Spain; 2Ophthalmology Unit, Faculty of Medicine, University of Valencia, Valencia, Spain; 3Molecular Ophthalmology Unit, Faculty of Medicine, University of Valencia, Valencia, Spain; 4Consellería de Sanitat (Valencian Regional Health Ministry), Valencian Autonomous Government, Valencia, Spain; 5IOVA – Valencia Ophthalmology Institute, Valencia, Spain; 6Hospital Universitario Doctor Peset, Valencia, Spain; 7Santiago Grisolía Eye Research Laboratory, FISABIO, Valencia, Spain; 8Specialised Medical Centre Alboraya, Valencia, Spain; 9Specialised Medical Centre Monteolivete, Valencia, Spain; 10Department of Ophthalmology, La Fe Hospital, Valencia, Spain; 11IMED Hospital, Valencia, Spain; 12Oftalvist Clinic, Valencia, Spain; 13European University of Valencia, Valencia, Spain
Purpose: To investigate the safety and efficacy of sterile isotonic seawater washes vs standard treatment with carmellose artificial tears in dry eye syndrome (DES).
Patients and methods: This is a randomized multicenter prospective study with 12 weeks of follow-up. A group of patients with DES (N=60) were treated with seawater spray (Quinton®) five times daily, and another similar group (N=60) were treated with carmellose artificial tears eyedrops (Viscofresh® 0.5%) five times a day. The parameters studied and measured were as follows: Ocular Surface Disease Index questionnaire score, Schirmer I test (without anesthesia) score, tear osmolarity (TearLab®), tear breakup time, tear meniscus height (meniscography OCT), fluorescein corneal staining score (National Eye Institute scale), lissamine green conjunctival staining score, and levels of IL-1 beta and IL-6 in tears (Luminex® 200).
Results: In the group treated with seawater, symptoms decreased by 68%, and the decrease was 26% statistically superior to the group treated with carmellose artificial tears eyedrops (P<0.001). Levels of IL-1 beta and IL-6 in tears significantly decreased in the seawater group compared to the carmellose artificial tears group (19%/17% vs 52%/51%) (P<0.001). There were no statistically significant differences in the other measured parameters. There were no cases of poor tolerance or side effects.
Conclusion: Administration of seawater is more effective than treatment with carmellose artificial tears in reducing symptoms and pro-inflammatory molecules (IL-1 beta and IL-6) in tears of patients with DES.
Keywords: dry eye syndrome, isotonic seawater, artificial tears, carmellose, IL-1 beta, IL-6, quality of life
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