J Korean Ophthalmol Soc.  2008 Nov;49(11):1729-1736.

Efficacy of Vitamin A-containing Lubricant in Dry Eye Syndrome Evaluated by Impression Cytology

• Kim EC
• Joo CK

Abstract

PURPOSE
To evaluate the therapeutic effect of topical vitamin A-containing lubricant in dry eye patients.
METHODS
Three hundred eyes of 150 patients with dry eye (Schirmer I test< or =10 mm, BUT< or =10 seconds) were divided into three groups. Preservative-containing artificial tears, preservative-free artificial tears, and vitamin A-containing lubricant were administrated to Groups 1, 2, and 3, respectively (N=50). We evaluated and checked symptom scores, tear film breakup time (tBUT), Schirmer I test results, corneal fluorescein stain scores, and impression cytology immediately and at 1, 2, and 3 months after treatment.
RESULTS
Mean tBUT and goblet cell density significantly increased from 5.06+/-1.25 to 6.76+/-1.21 sec and from 125.62+/-61.52 to 192.86+/-69.38 cell/mm2, respectively, after 2 months in group 3 (P<0.05). Impression cytology grade significantly decreased from 2.14+/-0.38 to 1.67+/-0.41 after 2 months in group 3 (P<0.05). The Schirmer I test score significantly increased from 9.12+/-4.15 to 12.83+/-0.96 mm, and the corneal stain score decreased from 2.13+/-0.95 to 1.18+/-0.68 after 3 months in group 3 (P<0.05).
CONCLUSIONS
The improvement of symptoms and the stabilization of tear films and ocular surfaces suggested that treatment with vitamin A-containing lubricant for dry eye was effective.

Keyword

Dry eye; Impression cytology; Vitamin A-containing lubricant

MeSH Terms

Dry Eye Syndromes
Eye
Fluorescein
Goblet Cells
Humans
Ophthalmic Solutions
Tears
Vitamins
Fluorescein
Ophthalmic Solutions
Vitamins

Figure

• 

  Figure 1 . Change from the baseline in blurred vision symptom scale. O-HU=Lacure®; O-RFR=Refresh plus®; O-viva=Viva®; Mean value±standard error. Graded on a symptom scale from 0 to 4. Statistically significant decreases of blurred vision from baseline at all follow-up visits in group 3 are shown (* P<0.05 by Mann-Whitney U Test).

• 

  Figure 2 . Change from the baseline in tear breakup time. O-HU=Lacure®; O-RFR=Refresh plus®; O-viva Viva®; Mean value±standard error. The increase from the baseline in tear breakup time (sec) was statistically significant in group 3 at 2 months and 3 months. (* P<0.05 by paired-T-test).

• 

  Figure 3 . Change from baseline in Schirmer I test. O-HU: Lacure®; O-RFR: Refresh plus®; O-viva: Viva® Mean value± standard error. The increase from baseline in Schirmer test value (mm) was statistically significant in groups 3 at 3 months. (* P<0.05 by paired-T-test).

• 

  Figure 4 . Change from the baseline in impression cytology grade. O-HU=Lacure®; O-RFR=Refresh plus®; O-viva=Viva®; Mean value±standard error. The decrease from the baseline in impression cytology grade was statistically significant in group 3 at 2 months and 3 months. (* P<0.05 by Mann- Whitney U Test).

• 

  Figure 5 . Example of impression cytology after 3 months in each group. Group 1=Lacure®; Group 2=Refresh plus®. Group 3= Viva®. There was no significant improvement in impression cytology after 3 months in group 1 (A=Stage 3-initial; B=Stage 3-after 3 months) and group 2 (C=Stage 3-initial; D=Stage 3-after 3 months). But improvement of impression cytology was shown after 3 months in group 3 (E=Stage 3-initial, F=Stage 2-after 3 months) (×100, PAS-hematoxylin stain).

• 

  Figure 6 . Change from baseline in goblet cells density. O-HU: Lacure®, O-RFR: Refresh plus®, O-viva: Viva®; Mean value±standard error. The increase from baseline in goblet cells density (cell/mm2) was statistically significant in group 3 at 2 months and 3 months. (* P<0.05 by paired-T-test).

• 

  Figure 7 . Change from the baseline in corneal stain score. O-HU=Lacure®; O-RFR=Refresh plus®; O-viva=Viva®; Mean value±standard error. The decrease from baseline in corneal stain score was statistically significant in group 3 at 3 months. (* P<0.05 by Mann-Whitney U Test).

Reference

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