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Combination of hyaluronic acid, carmellose, and osmoprotectants for the treatment of dry eye disease

Authors Mateo Orobia AJ, Saa J, Ollero Lorenzo A, Herreras JM

Received 23 November 2017

Accepted for publication 4 January 2018

Published 6 March 2018 Volume 2018:12 Pages 453—461

DOI https://doi.org/10.2147/OPTH.S157853

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Antonio José Mateo Orobia,1 Jorge Saa,2 Alberto Ollero Lorenzo,3 José María Herreras4,5

1Cornea and Ocular Surface Unit, Aragón Healthcare Research Institute (Instituto de Investigación Sanitaria de Aragón), Miguel Servet University Hospital, Zaragoza, Spain; 2Ophthalmology Department and Research Unit of Jove Hospital Foundation, Gijón, Spain; 3Cornea and Ocular Surface Unit, Meixoeiro Hospital, Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain; 4Valladolid University Clinical Hospital, Valladolid, Spain; 5University Institute of Applied Ophthalmobiology (IOBA [Instituto Universitario de Oftalmobiología Aplicada]). Miguel Delibes Campus, Paseo de Belén, Valladolid, Spain

Background: Dry Eye Disease (DED) is a multifactorial disease, with a high prevalence, that can have a great impact on the quality of life of patients. The first step of treatment includes the use of lacrimal substitutes composed of polymers, possible to associate osmoprotectant agents to the lacrimal substitutes. The aim of this article is to analyze the properties of the combination of hyaluronic acid (HA), carmellose, and osmoprotectors (Optava Fusion®; Allergan, Inc., Irvine, CA, USA) on DED. General considerations on the use of artificial tears are also proposed.
Methods: A group of ophthalmologists, experts in the management of the ocular surface, analyzed different aspects related to DED; among them, the use of artificial tears in general and the properties of the combination of HA, carmellose, and osmoprotectors, in particular, were discussed. A review of the literature was carried out, which included different articles published in Spanish, English, and French until April 2017.
Conclusions: DED is a common chronic pathology that usually requires sustained treatment. In addition, the combination of HA, carmellose, and osmoprotectors has proven to be effective in the treatment of symptoms and signs of dry eye by the synergistic action of all its components. This review provides key elements to help ophthalmologists who begin in the management of DED.

Keywords: dry eye disease, artificial tears, hyperosmolarity, osmoprotectants, hyaluronic acid, carmellose

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