Effect of tear substitutes with various sodium hyaluronate levels on the condition of eye anterior segment in dry eye syndrome patients
G.I. Drozhzhina, Dr. Sc. (Med.), Prof.
T.B. Gaidamaka, Dr. Sc. (Med.)
L.F. Troichenko, Cand. Sc. (Med.)
Filatov Institute of Eye Diseases and Tissue Therapy, NAMS of Ukraine
Odessa, Ukraine
E-mail: cornea@te.net.ua
The purpose of the present paper was to compare the effect of tear substitutes with various sodium hyaluronate levels (0.21% and 0.4%) on eye anterior segment condition and to determine the informative value of various diagnostic tests in dry eye syndrome patients
Materials and methods We followed up 40 patients (80 eyes), aged (57.8±7.5SD), with moderate dry eye syndrome (DES). All the patients were divided into two groups: group I included 20 patients (40 eyes) receiving 0.21% Optinol eye drops; group II included 20 patients (40 eyes) receiving 0.4% Optinol eye drops. Ophthalmic examination included Ocular Surface Disease Index (OSDI), biomicroscopy of the anterior chamber, fluorescence microscopy, tear break-up time for determining tear film stability, Schirmer’s I test and Jones' Schirmer II test to measure total and basal tear production, respectively; and best corrected visual acuity measurement.
Results The use of hyaluronic acid-based tear substitute, 0.21% and 0.4% Optinol, showed good therapeutic efficacy and drug tolerability. The use of 0.21% and 0.4% Optinol eye drops significantly increased subjective complaints of DES patients, which is evidenced by an OSDI index. For diagnostics of  condition of the anterior eye segment in DES, it is most appropriate to use Schirmer II test, TBUT and LWE assessment which are most sensitive both in DES diagnostics and assessment of treatment quality. Since the 0.4% Optinol eye drops have a more pronounced moistening, anti-inflammatory, and protective action, it is reasonable to use them in the treatment of dry eye syndrome which is accompanied with apparent ocular surface tissue inflammation.
Key words: dry eye syndrome, 0.21% and 0.4% sodium hyaluronate
1.    Berezov TT, Korovkin BF. [Biological chemistry]. M.: Meditsina; 2002.704p. Russian.
2.    Blinnikova VV. [Pathogenic rational for local therapy of experimental adjuvant arthritis using sodium hyaluronate]. Author’s thesis for Cand. Sc. (Med). Saratov; 2006. 18p. Russian. 
3.    Brzheskii VV, Somov EE. [Corneal conjunctival xerosis (diagnostics, clinic, treatment)]. Saint Petersburg: Saga; 2002. 142p. Russian.  
4.    Maichuk IuF, Iani EV. [Drug of a new pathogenic action in dry eye therapy]. Kataraktalnaia i refraktsionnaia khirurgiia. 2011;11(2):2-7. Russian. 
5.    Pavlova VN, Pavlov GG. [Articular cartilage and synovial membrane: specific of interaction in norm and in disease. [Local therapy in rheumatic disorders: Proceedings of All-Union conference. M.: 1988; 111-2. Russian.
6.    Somov EE. [Ethiopathogenetic basis of dry eye syndrome and treatment approach principles]. Proceedings of jubilee scientific practical conference dedicated to 75 anniversary of the first pediatric ophthalmology department in Russia. Saint Petersburg. 1-16 October 2010. 482-8. Russian.   
7.    Abatangelo G.  Hyaluronan: biological role and function in articular joint / G.Abatangelo, M.O'Regan // Eur. J. Rheum. Inflam. – 1995. – V.15. – P.9-16.
8.    Ammar DA, Noecker RJ, Kahook MY. Effects of benzalkonium chloride-preserved, polyquad-preserved, and sofZia-preserved topical glaucoma medications on human ocular epithelial cells. Adv. Ther. 2010;27:1-9.
9.    Ayaki M, Yaguchi S, Iwasawa A. Cytotoxicity of ophthalmic solution with and without preservatives to human corneal endothelial cells, epithelial cells and conjunctival epithelial cells. Clin. Exp. Ophthalmol. 2008;36:553-9
Crossref   Pubmed
10.    Bucher F, Bachmann B,  Bock F, Gross D,  Cursiefen C, Kruse FE. Impact of hyaluronic acid, panthenol and its combination on epithelial wound healing in murine corneas. Investigative Ophthalmology & Visual Science. 2009;4(50):6285.
11.    Bischoff  G, Khaireddin R. Lipidsubstitution bei kontaktlinsenassoziiertem Trocken Auge.  Aktuelle Kontaktologie. Sept. 2011:1-4.
12.    Carson SE, Wolf J. Interaction between synoviocytes and extracellular matrix in vitro. Ann. Rheum. Dis. 1995; 54:413-6.
Crossref   Pubmed
13.    Jones LT. The lacrimal secretory system and its treatment. Amer. J. Ophthalmol. 1966;62(1):47-60.
Crossref   Pubmed
14.    Mishima S, Kubota Z, Farris RL.  The tear flow dynamics in normal and in keratoconjunctivitis sicca cases. In: Solanes M. P., editor. Ophthalmology; Proceedings of the XXI International Congress; Mexico, DF. 8–14 March, 1970; Amsterdam: Excerpta Medica; 1971. 1801–5.
15.    Nichols K, Foulks G, Bron A. The International Workshop on Meibomian Gland dysfunction. Invest. Opthalmol. and Vis. Sci. 2011;52:1917-29.
Crossref   Pubmed
16.    Dougberty BE, Nichols JJ, Nicbols KK. Ocular Surface Disease. Rasch Analysis of the Ocular Surface Disease. Invest. Ophthalmol. Vis. Sci. 2011;52(12):8630-35.
17.    Pult H, Riede-Pult BH, Murphy PJ. The relation between blinking and conjunctival folds and dry eye symptoms. Optom Vis Sci. 2013;90(10):1034-9.
18.    Schirmer O. Studie zur Physiologie und Pathologie der Tranenabsonderung und Tranenabfuhr. Graefes Arch. Ophthalmol. 1903;56(2):197-291.
19.    The international Dry Eye Workshop (DEWS). The Ocular Surface 2007;5:65-90.
20.    Varikooty J, Srinivasan S, Subbaraman L, Woods CA, Fonn D, Simpson TL, Jones LW. Variations in observable lid wiper epitheliopathy (LWE) staining patterns in wearers of silicone hydrogel lenses. Cont Lens Anterior Eye. 2015;38(6):471-6.