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Two dry eye drop formulations compared
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Comparison of two types of eye drops, one containing hyaluronic acid and the other containing carboxymethylcellulose, in patients with moderate dry eye disease showed efficacy of both products.
The study was carried out in 10 centers in France and included 80 patients with moderate dry eye disease and nonviral keratoconjunctivitis or keratitis divided into two groups. One group received a sterile preservative-free solution containing 0.1% hyaluronic acid (Hylo Confort, Ursapharm) and the other received a sterile solution containing 0.5% carboxymethylcellulose (Optive, Allergan). Instillation for both groups was three times daily.
Of the two components of moisturizing eye drops, the authors wrote, “HA has excellent moisturizing and mucus-layer adhesive properties and is found in the physiological tear fluid. CMC is an anionic cellulose derivate, provides excellent bioadhesive characteristics, and increases tear-retention time.”
Primary endpoint was change in ocular surface as seen on lissamine green and fluorescein staining between baseline and day 35. Secondary measures at day 84 were ocular surface staining score, tear breakup time (TBUT) and subjective symptoms of dryness, grittiness, stinging, fatigue, pain and itching by the Ocular Comfort Index (OCI) questionnaire.
On day 35, staining was reduced by 47.7% in the hyaluronic acid group and by 41.2% in the carboxymethylcellulose group. Progressive decrease was observed up to day 84, reaching 64.5% in the hyaluronic acid group and 56.4% in the carboxymethylcellulose group compared with baseline. TBUT values slightly improved in both groups. OCI scores showed reduction of all symptoms.
“Treatment of [dry eye disease] with 0.1% HA or 0.5% CMC eye drops is efficacious and safe in patients with moderate DED, with a more favorable trend for 0.1% HA eye drops,” the authors concluded. – by Michela Cimberle
Disclosure: Gross reports she is an employee of Ursapharm. Please see the study for the other authors’ financial disclosures.
Perspective
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Preeya K. Gupta, MD
In this study, 0.1% hyaluronic acid was found to be noninferior to 0.5% carboxymethylcellulose. Several parameters, including patient comfort, showed significantly more favorable outcomes with hyaluronic acid at day 35.
These findings suggest that 0.1% hyaluronic acid drops may provide a more rapid reduction in symptoms and signs of dry eye disease, but further studies comparing these two molecules in a randomized trial would be of value to determine which achieves greater success in treating dry eye disease patients in addition to learning how rapidly each molecule can work.
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