Efficacy of Nonpreserved Sodium Hyaluronate Artificial Tears in Dry Eye Disease Patients Treated with Prostaglandin Analogs for Primary Open-Angle Glaucoma: A Prospective, Nonrandomized, Open-Label Pilot Study

Giulia Coco; Danilo Iannetta; Igino Febbraro; Ester Elmo; Gianluca Manni

doi:10.1155/2022/1320996

Efficacy of Nonpreserved Sodium Hyaluronate Artificial Tears in Dry Eye Disease Patients Treated with Prostaglandin Analogs for Primary Open-Angle Glaucoma: A Prospective, Nonrandomized, Open-Label Pilot Study

J Ophthalmol. 2022 Dec 2:2022:1320996. doi: 10.1155/2022/1320996. eCollection 2022.

Authors

Giulia Coco¹, Danilo Iannetta², Igino Febbraro¹, Ester Elmo¹, Gianluca Manni^{1

3}

Affiliations

¹ Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy.
² Ophthalmology Unit, DIMES, Alma Mater Studiorum, Ophthalmology Department, University of Bologna, S. Orsola-Malpighi Teaching Hospital, Bologna 40138, Italy.
³ IRCCS-Fondazione Bietti, Rome, Italy.

Abstract

Purpose: Dry eye disease (DED) can be triggered using preserved ophthalmic formulations or prostaglandin analogs. In this prospective, nonrandomized, open-label pilot study, we evaluated the efficacy of a 0.15% hyaluronic acid (HA) nonpreserved ophthalmic formulation in decreasing DED symptoms in patients with open-angle glaucoma treated with prostaglandin analogs.

Methods: 30 patients with DED receiving chronic treatment with prostaglandin analogs for primary open-angle glaucoma or ocular hypertension were administered ophthalmic formulations 3 times daily for 12 weeks. Foreign body sensation, burning, stinging, dryness, pain, frequency of symptoms, Ocular Surface Disease Index (OSDI), conjunctival hyperaemia, corneal fluorescein staining (CFS), tear film break-up time (TBUT), best-corrected visual acuity, Schirmer test results, and 25-item National Eye Institute Visual Function Questionnaire score between the baseline and 4 and 12 weeks were evaluated.

Results: The analysis shows that all primary endpoints improved; in particular, burning sensation and the frequency of symptoms after 4 and 12 weeks of treatment (p < 0.001) and dryness and pain after 12 weeks of treatment (p < 0.001 and p=0.03, respectively) were reduced significantly. Secondary outcomes confirmed the positive results, with a statistically significant change in the OSDI score and CFS between the baseline and 4 (p=0.02 and p < 0.001, respectively) or 12 weeks (both p < 0.001) and TBUT after 4 weeks (p=0.01). Conjunctival hyperaemia improved in both eyes in >90% of cases at 12 weeks of treatment.

Conclusion: The present study shows that the ophthalmic formulation containing 0.15% HA has a promising beneficial effect on reducing the signs and symptoms of DED in patients treated with prostaglandin analogs.