methylcellulose and Dry-Eye-Syndromes

Despite the use of modern methods of prevention, at least 10% of patients operated on for ophthalmic indications not develop corneal erosion as the indirect complication of general anesthesia.. To reduce the number of ophthalmic complications of general anesthesia by prophylactic use of new mito- chondria-targeted antioxidants - Vizomitin (eye drops).. 70 patients, which was supposed to perform the average duration of operations under general anesthesia were randomized into 3 groups depending on the method specific (pharmacological) prevention of corneal erosions: (1) control (specic (pharmacological) prevention was not carried out), (2), using preparation "natural tear, and (3) "Vizomitin" preparation. Postoperative biomicroscopy was performed to assess the condition of the cornea, tear film stability was measured and the height of the tear meniscus.. When using eye drops "Vizomitin" value is an indicator of stability of the tear film on the 3rd day after the operation more than in the control group of patients by 51% (p = 0.012) and patients groups, natural tear by 57% (p = 0.013). Surgical interventions performed under general anesthesia, leading to an increase in the number ofpatients with decreased tear meniscus height index of the control group with 4 to 7 patients (p = 0.30) in the group of natural tear from 3 to 11 patients (p = 0.008) . In the group with drug "Vizomitin" the number of such patients is reduced from 7 to 1 (p = 0.018).. In the surgical procedures under general anesthesia eye drops "Vizomitin" effectively prevents the devel- opment of corneal erosion.

Topics: Adult; Anesthesia, General; Antioxidants; Benzalkonium Compounds; Cornea; Drug Combinations; Dry Eye Syndromes; Humans; Lubricant Eye Drops; Methylcellulose; Middle Aged; Mitochondria; Plastoquinone; Postoperative Complications; Treatment Outcome; Young Adult

This article presents the results of an international, multicenter, randomized, double-masked, placebo-controlled clinical study of Visomitin (Mitotech LLC, Moscow, Russian Federation) eye drops in patients with dry eye syndrome (DES). Visomitin is the first registered (in Russia) drug with a mitochondria-targeted antioxidant (SkQ1) as the active ingredient.. In this multicenter (10 sites) study of 240 subjects with DES, study drug (Visomitin or placebo) was self-administered three times daily (TID) for 6 weeks, followed by a 6-week follow-up period. Seven in-office study visits occurred every 2 weeks during both the treatment and follow-up periods. Efficacy measures included Schirmer's test, tear break-up time, fluorescein staining, meniscus height, and visual acuity. Safety measures included adverse events, slit lamp biomicroscopy, tonometry, blood pressure, and heart rate. Tolerability was also evaluated.. This clinical study showed the effectiveness of Visomitin eye drops in the treatment of signs and symptoms of DES compared with placebo. The study showed that a 6-week course of TID topical instillation of Visomitin significantly improved the functional state of the cornea; Visomitin increased tear film stability and reduced corneal damage. Significant reduction of dry eye symptoms (such as dryness, burning, grittiness, and blurred vision) was also observed.. Based on the results of this study, Visomitin is effective and safe for use in eye patients with DES for protection from corneal damage.. Mitotech LLC.

Topics: Adult; Benzalkonium Compounds; Cornea; Double-Blind Method; Drug Combinations; Dry Eye Syndromes; Female; Fluorescein; Humans; Male; Methylcellulose; Middle Aged; Ophthalmic Solutions; Plastoquinone; Tears; Treatment Outcome; Visual Acuity

To compare the efficacies of sodium hyaluronate, hydroxypropyl methylcellulose (HPMC), and a new oil-in-water emulsion (Emustil unidose; SIFI) in the management of lipid-deficient dry eye.. Seventy-five subjects with dry eye were randomly divided into 3 groups. Each was allocated sodium hyaluronate, HPMC, or emulsion eyedrops to be used four times daily for 90 days. Parameters were measured at baseline, 30 days, and 90 days. A compliance visit was performed at days 7 and 60.. Significant reduction (P < 0.05) in evaporation and improvement in symptoms in all groups were found. No statistically significant increase in tear turnover rate (TTR) was found with any solution. A significant difference in tear stability and noninvasive tear break-up time (NITBUT) was found in the emulsion and sodium hyaluronate groups but not in the HPMC group (P > 0.05). There was a significant decrease in osmolarity and corneal staining in the emulsion group (P < 0.001) but not in the sodium hyaluronate or HPMC group (P > 0.05).. A significant reduction in evaporation and improvement in symptoms in all therapy groups were found from baseline to 90 days. However, no significant effect was seen on TTR for any group. The emulsion drops were shown to perform best, improving tear stability, and decreasing osmolarity and corneal staining. These results are consistent with improvements in the lipid layer of the tear film as a result of prolonged use of emulsion drops.

Topics: Adult; Dry Eye Syndromes; Emulsions; Female; Humans; Hyaluronic Acid; Hypromellose Derivatives; Interferometry; Male; Methylcellulose; Middle Aged; Ophthalmic Solutions; Tears

To assess the short-term efficacy of hypotonic 0.18% sodium hyaluronate in patients with evaporative tear-sufficient dry eye due to lipid tear deficiency (LTD).. This was a randomised, double-blind, controlled, exploratory study. A total of 10 patients with dry eye due to LTD were treated as follows: one drop of hypotonic 0.18% sodium hyaluronate in one eye and one drop of isotonic 0.3% hydroxypropyl-methylcellulose (HPMC)/0.1% dextran in the other eye. Non-invasive tear film break-up time (NIBUT) evaluated by using a tear scope with grid pattern and subjective ocular symptoms of dry eye were assessed at 15, 30, 60 and 90 min after instillation.. Both sodium hyaluronate and HPMC/dextran caused a significant (p<0.05) improvement in NIBUT and symptoms. Mean (SD) NIBUT in the sodium hyaluronate group was 3.2 (1.0), 6.4 (2.8), 5.5 (1.9), 5.3 (1.3) and 3.9 (1.7) s at 0, 15, 30, 60 and 90 min, respectively, compared with 3.6 (1.9), 5.5 (3.2), 5.0 (1.5), 4.4 (2.2) and 3.5 (1.2) s in the HPMC/dextran group. However, increase in NIBUT was significantly (p<0.05) greater and longer in the sodium hyaluronate group than in the HPMC/dextran group.. Treatment with sodium hyaluronate and HPMC/dextran eye drops is useful for treating patients with dry eye due to LTD. However, sodium hyaluronate caused a significantly (p<0.05) greater increase in NIBUT values than HPMC/dextran in such patients.

Topics: Adult; Aged; Double-Blind Method; Dry Eye Syndromes; Female; Humans; Hyaluronic Acid; Hypromellose Derivatives; Lipids; Male; Methylcellulose; Middle Aged; Ophthalmic Solutions; Tears; Treatment Outcome

To determine the effect of an oil-in-water emulsion eye drop compared with a conventional dry eye supplement (hypromellose) on tear physiology in dry eye.. A randomized parallel, longitudinal, and investigator-masked study of the efficacy of 1.25% castor oil emulsion and 0.32% hypromellose solution was carried out. A total of 53 patients with mild to moderate dry eye (27 in emulsion group and 26 in hypromellose group) were recruited for the study. Patients were enrolled if they reported at least 2 symptoms on a McMonnies Dry Eye Questionnaire together with 1 of the following screening tests: noninvasive tear breakup time (5-10 seconds) and Schirmer test without anesthesia (2-5 mm in 5 minutes). Patients were instructed to use the test solutions 3 times a day for 30 days. Tear production, evaporation, lipid layer structure, and osmolality were measured before and 30 days after use of the drops.. A statistically significant decrease was seen after 1 month in tear evaporation rates with both emulsion (7.25 +/- 5.43 g/m2/h) and hypromellose (2.02 +/- 4.75 g/m2/h). However, the decrease with emulsion was significantly greater than with hypromellose (P < 0.001). Lipid layer structure improved from day 1 to day 30 of the study with the emulsion but not with the hypermellose. No significant changes were seen in tear production and osmolality with either of the drops.. The oil-water emulsion was more effective in reducing tear evaporation than hypromellose after repeated application over a 1-month period. This finding signifies the potential of the emulsion in the management of evaporative dry eye.

Topics: Adult; Castor Oil; Dry Eye Syndromes; Emulsions; Female; Follow-Up Studies; Humans; Hypromellose Derivatives; Interferometry; Male; Methylcellulose; Ophthalmic Solutions; Osmolar Concentration; Patient Compliance; Severity of Illness Index; Surveys and Questionnaires; Tears; Treatment Outcome; Water

We report the results of 3 studies conducted to evaluate the performance of a 1.0% carboxymethylcellulose (CMC) mid-viscosity artificial tear compared to currently marketed low-viscosity tears.. First, a single-center, double-masked, randomized, crossover study was performed to compare the effect on the Ocular Protection Index (OPI) of the mid-viscosity tear compared to low-viscosity tears in 39 subjects with mild to moderate dry eye. Second, a 1-month, 2-arm, parallel, randomized double-masked clinical study assessed objective signs and subjective symptoms of dry eye in 103 subjects with mild to moderate dry eye. Third, in a 1-month home-use test, 465 artificial tear users compared the mid-viscosity tear or a current low-viscosity tear to their current artificial tear.. The OPI study showed prolonged tear breakup time and improved OPI for at least 20 minutes after instillation of the mid-viscosity tear. The low-viscosity tears showed improvements for 5 to 10 minutes. The 1-month clinical study showed a significant reduction in staining and dry eye symptoms after 1 week of treatment, with a further reduction in staining after 1 month in the mid-viscosity group. Subjects provided more reports of blur with the mid-viscosity tear than with a low-viscosity tear, but equivalent overall acceptability. The home use test showed general acceptability of the mid-viscosity tear, including more subjects indicating that it was needed less frequently than their prior low-viscosity tear.. This 1% CMC mid-viscosity tear showed protection of the ocular surface after instillation and significant reduction in signs and symptoms of dry eye. Improvements were greater than with low-viscosity tears. The mid-viscosity artificial tear was rated well in comfort, duration of benefit, and general acceptability.

Topics: Carboxymethylcellulose Sodium; Cross-Over Studies; Double-Blind Method; Dry Eye Syndromes; Female; Humans; Hypromellose Derivatives; Male; Methylcellulose; Middle Aged; Ophthalmic Solutions; Surveys and Questionnaires; Tears; Viscosity

To evaluate efficacy, safety and comfort of a 0.3% hypromellose (HM) eye gel (GenTeal Lubricant Eye Gel), with a sodium perborate preservative system and carbomer gelling agent, in patients with dry eye.. Patients with moderate-to-severe dry eye syndrome were enrolled in this open label study and assessed at three visits; a screening consultation (baseline) and two follow-up visits on day 14 (+/- 4 days) and day 28 (+/- 4 days). All screening, evaluation and follow-up visits were carried out at the Tauber Eye Center (formerly the Hunkeler Eye Center), Kansas City. Patients were treated with the product over a 4-week period. They were instructed to use the product at least two times daily, more if necessary, with one drop instilled into the conjunctive sac of both eyes.. Efficacy was measured by ocular symptoms (burning, stinging, foreign body sensation, dryness, pain/soreness and photophobia), ocular signs (eyelid erythema, bulbar conjunctival injection and corneal superficial punctate keratitis score), tear breakup time and global assessment of ocular comfort. Tolerability measures were change from baseline in best corrected Snellen visual acuity and monitoring of adverse events.. Thirty-seven patients completed this study. The mean sum symptom score at each visit was significantly lower compared with baseline with approximately 30% reduction in the sum symptom score at 2 weeks and approximately 33% at 4 weeks after treatment initiation (p < 0.001). Mean individual symptom scores for dryness, stinging and foreign body sensation decreased by approximately 40% at the end of the study (p < 0.02). Tear breakup time increased from baseline by 53% and 59% at 2 and 4 weeks, respectively (p < 0.001). The proportion of patients reporting a global evaluation of slightly better or much better was approximately 74% at 2 weeks and 78% at 4 weeks after treatment initiation. The product was well tolerated, with one related adverse event reported.. In a small, open-label study, this 0.3% HM eye gel showed statistically significant effects in relieving ocular symptoms and provides a well-tolerated formula that effectively reduced symptoms and improved ocular comfort in patients with dry eye syndrome.

Topics: Adult; Dry Eye Syndromes; Female; Humans; Hypromellose Derivatives; Male; Methylcellulose; Middle Aged; Ophthalmic Solutions; Severity of Illness Index

This study evaluated the clinical performance of contact lens wear, primarily comfort and dryness during the daytime and at the end of the day, associated with the use of a multipurpose solution containing hydroxypropyl methylcellulose (HPMC), COMPLETE ComfortPLUS (Allergan, Irvine, CA) compared to a citrate-based multi-purpose disinfecting solution used without manual rubbing, NO RUB OPTI-FREE EXPRESS (Alcon, Ft. Worth, TX).. This randomized, investigator-masked, cross-over study was conducted with 64 subjects who underwent adaptation and were planned-replacement lens wearers. Each solution was used by the subject for 1 month, with a 1-week wash-out period during which the subject's own solutions were used. When new solutions were issued, new contact lenses also were dispensed.. The level of comfort, the primary endpoint of the study, in the evening (on a 50-point scale) was rated better with OPTI-FREE EXPRESS at the end of the 1-month period of wear (mean 39 vs. 37, P=0.03). Dryness, the most frequently reported symptom, occurred at a similar level of rating with both care systems (P >0.05). Few other clinically significant differences between the regimens were noted.. The overall clinical performance of the citrate-based solution used without manual rubbing was similar to that of the solution containing HPMC. The subjective results of comfort-level and dryness with the two regimens demonstrated that the inclusion of HPMC did not provide unique performance advantages.

Topics: Adult; Aged; Citrates; Contact Lens Solutions; Contact Lenses; Cross-Over Studies; Double-Blind Method; Dry Eye Syndromes; Eye; Female; Humans; Hypromellose Derivatives; Incidence; Male; Methylcellulose; Middle Aged; Patient Satisfaction

The addition of the ocular lubricant hydroxypropyl methylcellulose (HPMC) to a multipurpose contact lens solution conditions the hydrogel lens surface. This investigation reports the clinical benefits to contact lens wearers and the improved physical properties of the solution with HPMC added.. One-hundred forty-seven subjects wearing a variety of hydrogel lenses used a multipurpose solution with and without addition of HPMC and were assessed for product comfort and preference. In the laboratory, conditioning by HPMC was demonstrated in fluid coating, dynamic contact angle, uptake of fluid on hydrogel lenses, and release of HPMC from lenses after soaking.. Lens wearers reported the multipurpose solution with HPMC more comfortable, including measures relating to maintaining lens moisture over time. The multipurpose solution with HPMC produced a thicker and longer-lasting layer of fluid on hydrogel lenses and other plastics than other multipurpose solutions. HPMC was found to adsorb to both group 1 and 4 lens materials and release gradually, with detectable amounts releasing from the lens beyond 12 hours.. The conditioning properties of the multipurpose solution with HPMC produce improved wetting of lenses and enhanced lens wearing comfort. Binding of HPMC to the lens surface and subsequent time-release is the probable mechanism for these benefits.

Topics: Contact Lens Solutions; Contact Lenses, Hydrophilic; Cross-Over Studies; Double-Blind Method; Dry Eye Syndromes; Humans; Hydrogel, Polyethylene Glycol Dimethacrylate; Hypromellose Derivatives; Lubrication; Methylcellulose; Patient Satisfaction; Wettability

Our purpose was to evaluate the efficacy of a new formulation of methylcellulose, preservative-free 0.5% hydroxypropyl methylcellulose (HPMC), for the treatment of dry eye. In the clinical part of our study, two groups of dry-eye patients, those with Sjögren's syndrome (SS) and those without (non-SS), were treated topically with 0.5% HPMC and evaluated for symptoms, ocular surface vital staining, tear breakup time (BUT), and tear evaporation rate from the ocular surface at 40% ambient humidity (TEROS40). In the in vivo part of the study, rose bengal uptake was measured in human conjunctival epithelial cells, which were cultured and incubated with or without 0.5% HPMC. Although symptoms improved in both groups, rose bengal and fluorescein staining and BUT improved significantly only in the SS group. TEROS40 increased for 30 min after instillation of 0.5% HPMC, but not after use of 0.1% sodium hyaluronate or saline-based artificial tears. Rose bengal uptake by cultured conjunctival epithelial cells was blocked by 0.5% HPMC. These findings suggest that 0.5% HPMC provides long coverage of and protection for the ocular surface. Patients with severe dry eye, such as in SS, are good candidates for this treatment.

Topics: Adult; Aged; Conjunctiva; Dry Eye Syndromes; Female; Humans; Hypromellose Derivatives; Male; Methylcellulose; Middle Aged; Rose Bengal; Sjogren's Syndrome; Staining and Labeling; Tears

To compare the efficacy of three types of ocular lubricants in protecting corneal epithelial cells in dry eye animal models.. Ocular lubricants containing 0.1% or 0.3% sodium hyaluronate (SH), carboxymethylcellulose (CMC), or hydroxypropyl methylcellulose (HPMC) were tested. First, ocular lubricant containing 0.002% fluorescein was dropped onto the rabbit corneas. The fluorescein intensity as an index of retention was measured. Second, a rabbit dry eye model was made by holding the eye open with a speculum, and 50 μL of each ocular lubricant was dropped onto the cornea. After 3 hours, the corneas were stained with 1% methylene blue (MB), and the absorbance of MB was measured. Third, a rat dry eye model was treated with the ocular lubricants for 4 weeks, and the corneal fluorescein staining was scored. Eyes treated with physiological saline were used as controls. Finally, immunohistochemistry was used to analyze occludin, an epithelial barrier protein, in cultured human corneal epithelial cells pretreated with ocular lubricants and desiccated for 20 or 60 minutes.. Our results showed that 0.3% SH had a significantly longer retention time than the other lubricants (all P < 0.01). The absorbance of MB was significantly lower in the 0.3% SH group. The corneas of rats exposed to 0.3% SH had significantly lower fluorescein staining scores. A significantly higher number of occludin-positive cells were found after exposure to 0.3% SH than other lubricants.. Ocular lubricant containing 0.3% SH would be preferable to treat patients with dry eye syndrome.

Topics: Animals; Carboxymethylcellulose Sodium; Cornea; Disease Models, Animal; Dry Eye Syndromes; Hyaluronic Acid; Hypromellose Derivatives; Male; Methylcellulose; Ophthalmic Solutions; Rabbits; Rats; Treatment Outcome; Viscosupplements

To report a case of erythema multiforme major complicated by a central corneal delle.. Case report.. An 18-year-old man recovering from erythema multiforme major complained of blurred vision and grittiness. Slit-lamp examination revealed a central corneal depression; the overlying epithelium was intact, and the stroma was thinned but lacked inflammation. The patient underwent 2 months of treatment with lubrication and autologous serum. The thinning corneal stroma thickened, and the corneal curvature returned to normal without any further complications such as corneal perforation.. Erythema multiforme major caused upper tarsus deformity and dry eye, which resulted in localized corneal dehydration and a central corneal delle.

Topics: Adolescent; Corneal Diseases; Dry Eye Syndromes; Erythema Multiforme; Eyelid Diseases; Humans; Hypromellose Derivatives; Male; Methylcellulose; Ophthalmic Solutions

To use a novel porcine dry eye model (pDEM) to study the effect of various artificial tears on corneal abrasion and epithelial cell death under severe "dry eye" conditions.. A 60-second lacrimation-blink interval, which simulates a severe dry eye condition, was set up with our novel pDEM. The corneal protective effect of lubricating the eye for 4 hours with Dulbecco phosphate-buffered saline (DPBS, as control; n = 20) and with 3 types of commercially available artificial tears (n = 17 for each) that contained different lubricating agents was studied. Effect was determined in terms of the change in fluorescein staining grade (on a 0-4 point scale with 0.5 increments) of the cornea and the number of dead cells (by trypan blue staining) on the corneal surface.. Median increase in fluorescein grading (median) in corneas treated for 4 hours with artificial tears containing sodium hyaluronate or hydroxypropyl methylcellulose was significantly (P < 0.002) smaller than with artificial tears containing balanced saline with an unknown demulcent or the DPBS control. The numbers of dead epithelial cells in the central corneas lubricated with artificial tears containing sodium hyaluronate or hydroxypropyl methylcellulose (229 +/- 71 and 221 +/- 65 [SD], respectively) were also significantly (P < 0.005) smaller than those in the corneas of eyes lubricated with artificial tears containing balanced saline with an unknown demulcent or DPBS alone (328 +/- 106 and 341 +/- 113, respectively).. Results show that artificial tears containing sodium hyaluronate or hydroxypropyl methylcellulose as lubricating agents give enhanced corneal protection against desiccation and show the use of this novel pDEM model in evaluating corneal protection from desiccation.

Topics: Animals; Cell Survival; Cornea; Disease Models, Animal; Dry Eye Syndromes; Epithelial Cells; Fluoresceins; Hyaluronic Acid; Hypromellose Derivatives; Methylcellulose; Ophthalmic Solutions; Swine; Trypan Blue

The aim of this study was to establish a method for analysis of tear film stability and thereby to investigate the effects of lubricants on corneal surface regularity and corneal epithelial damage in anesthetized rabbits with the eye held open. Saline-instilled and noninstilled eyes manifested a time-dependent increase in the corneal surface regularity index (SRI). In contrast, 0.1% hyaluronic acid (HA) prevented the increase in the SRI for up to 20 min after instillation. Methylene blue uptake into the damaged cornea was significantly greater in eyes that received saline than in those treated with HA. Whereas eyes instilled with 0.5% methylcellulose (MC) or 0.35% sodium carboxymethylcellulose (CMC) manifested an increase in the SRI similar to that apparent in those that received saline, 1.0% chondroitin sulfate (CS) prevented the increase in the SRI for up to 10 min after instillation. In conclusion, we have established a method for analysis of tear film stability in rabbits. Our results suggest that tear film stability is closely related to corneal surface damage and that topical instillation of 0.1% HA or 1.0% chondroitin sulfate warrants further investigation as a potential treatment for patients with dry eye.

Topics: Animals; Carboxymethylcellulose Sodium; Chondroitin Sulfates; Corneal Topography; Dry Eye Syndromes; Epithelium, Corneal; Hyaluronic Acid; Male; Methylcellulose; Ophthalmic Solutions; Rabbits

The purposes of this study were to establish a quantitative method for evaluating rabbit tear film status and investigate the efficacy of artificial tear preparations through ocular surface bathing or eye drop application.. The rabbit tear film was evaluated using a noninvasive specular reflection video recording system. The appearance of a tear break area (TBA) on the tear film images (7.4 mm2/mm) after 30 seconds of eye opening was quantified by image analysis. To induce disruption of the rabbit tear film, the ocular surface was challenged for 60 minutes with 1 ppm hypochloric acid (HOCl). Immediately after irrigation, artificial tear preparations composed of viscosity agents sodium hyaluronate (SH), hydroxypropylmethycellulose (HPMC), hydroxyethylcellulose (HEC), or chondroitin sulfate (CS) were applied to the rabbit eye through ocular surface bathing or eye drop application, and the recovery of the disrupted tear film was compared for each preparation.. A dramatic increase in TBA was observed immediately after the ocular surface was challenged with HOCl, and it returned to the initial level after 6 hours. Immediately after ocular surface bathing and eye drop application, a dramatic recovery of TBA was observed in all the test solution-treated eyes. One hour after treatments, prolonged amelioration of the tear film instability was observed after ocular surface bathing, but not by eye drop application, with the artificial tear preparations composed of HPMC or SH.. Ocular surface bathing with artificial tear preparations composed of a suitable viscosity agents could be useful in managing tear film instability.

Topics: Animals; Cellulose; Chondroitin Sulfates; Disease Models, Animal; Dry Eye Syndromes; Hyaluronic Acid; Hypochlorous Acid; Hypromellose Derivatives; Methylcellulose; Ophthalmic Solutions; Rabbits; Tears; Viscosity

Topics: Blepharoplasty; Blepharoptosis; Corneal Neovascularization; Corneal Opacity; Corneal Ulcer; Disease Progression; Dry Eye Syndromes; Ectropion; Humans; Hypromellose Derivatives; Male; Methylcellulose; Middle Aged; Ophthalmic Solutions; Pantothenic Acid; Postoperative Care; Tangier Disease

To compare the effect of artificial tears (0.5% carboxymethylcellulose [CMC] in lactate buffer vs. 0.3% hydroxypropyl methylcellulose and 0.1% dextran in bicarbonate buffer [HPMC]) on the preservation of ocular surface health in postoperative laser in situ keratomileusis (LASIK) patients.. Nonrandomized, comparative, retrospective analysis of a clinical database. Patients (n = 519; 985 eyes) had undergone LASIK in a single refractive surgery center performed by a single surgeon using the same LASIK technique (Nidek EC5000 laser and ACS keratome). Patients (n = 254) were given CMC (Refresh Plus/Cellufresh) or HPMC (Bion Tears) four times per day and were evaluated at presurgery, week 2, and months 1, 3, and 6. Included patients were those with complete clinical data through the month I follow-up visit.. There were no significant between-group differences in any baseline variable. Following LASIK, fewer CMC patients (n = 111) reported dry eye symptoms than HPMC patients (n = 143) at the week 2 (13.5% vs. 30.8%; P = .001) and month 1 (19.8% vs. 38.5%; P = .001) follow-up visits. CMC patients also had significantly lower mean ocular surface staining scores than HPMC patients at week 2 (0.09 vs. 0.30; P = .015) and month 1 (0.05 vs. 0.28; P = .008). There were no between-group differences in either measure at months 3 or 6 (P < or = .728).. CMC was more effective than HPMC in controlling dry eye symptoms and preserving ocular surface health in the immediate postoperative period in myopic post-LASIK patients, possibly due to the greater muco-adhesive properties of CMC. These results warrant further investigation as to the most effective postoperative LASIK lubricant.

Topics: Adult; Carboxymethylcellulose Sodium; Contrast Media; Dry Eye Syndromes; Eye; Female; Fluorescein; Health Status; Humans; Hypromellose Derivatives; Incidence; Keratomileusis, Laser In Situ; Male; Methylcellulose; Middle Aged; Ophthalmic Solutions; Retrospective Studies; Staining and Labeling; Surface Properties; Treatment Outcome

To investigate cell tolerance of three tear substitutes used in the treatment of dry eye syndromes.. Cytotoxicity tests were done on a continuous human conjunctival cell line using microplate cold light cytofluorimetry. Membrane integrity, DNA condensation and reactive oxygen species (ROS) production (hydrogen peroxyde and superoxide anion) were evaluated after 15 minutes of treatment or 15 minutes and 24 hours of cell recovery. Hyaluronic acid, hydroxypropyl methylcellulose associated with sodium perborate (HPMC) and carbomer 934P were tested at their commercial concentrations (respectively 0.18%, 0.3% and 0.3%) and after a 1/10 dilution.. Cell viability and chromatin condensation were not altered by hyaluronic acid for all concentrations and times tested. A decrease in membrane integrity was observed with 0.3% carbomer 934P after 24 hours of cell recovery and with 0.3% HPMC after 15 minutes. This decrease was amplified after 24 hours and associated with an apoptotic phenomenon. A H(2)O(2) production was observed with HPMC associated with sodium perborate and an O(2) production was found with hyaluronic acid diluted at 1/10.. Hyaluronic acid, carbomer and HPMC are in vitro well-tolerated even if HPMC induces a more important decrease of cell viability compared to the other drugs. Hyaluronic acid, with its rheologic properties, with no in vitro toxicity, seems to be efficient for dry eye patients.

Topics: Borates; Cells, Cultured; Chromatin; Conjunctiva; Dry Eye Syndromes; Epithelial Cells; Flow Cytometry; Free Radicals; Humans; Hyaluronic Acid; Hydrogen Peroxide; Hypromellose Derivatives; Methylcellulose; Ophthalmic Solutions; Reactive Oxygen Species; Superoxides; Time Factors

We have utilized hydroxypropyl methylcellulose in the therapy of 20 patients suffering from dry eye in the initial stage. The effects of the substance have been evaluated both from a clinical and a morphological standpoint. In particular, transmission and scanning electron microscopy were applied to investigate the ultrastructural features of the conjunctival epithelium before and after treatment. In addition, lectin cytochemistry was carried out to analyse semiquantitatively the presence of glycoconjugates in the conjunctival mucus produced by goblet and non-goblet epithelial cells. Hydroxypropyl methylcellulose did not improve the tear film stability as demonstrated by the clinical tests. The normal surface of the conjunctival epithelium did not appear recovered as well. Only a minimal increase in the density of the second mucus system vesicles was observed. From a cytochemical point of view, the content of glycosidic residues appeared altered in dry-eye patients both before and after treatment. This alteration can lead to changes in the physical and functional properties of the mucus, impairing its role as a surfactant. We conclude that the common treatment by means of lubrificant-like substances palliates the dryness condition. The search for a drug which reintegrates the correct composition of the conjunctival mucus should be seriously considered as a valid alternative.

Topics: Biopsy; Conjunctiva; Dry Eye Syndromes; Epithelial Cells; Female; Histocytochemistry; Humans; Hypromellose Derivatives; Lectins; Male; Methylcellulose; Microscopy, Electron; Microscopy, Electron, Scanning; Middle Aged; Tears