Comparative analysis of carmellose 0.5% versus hyaluronate 0.15% in dry eye: a flow cytometric study

Cornea. 2010 Feb;29(2):167-71. doi: 10.1097/ICO.0b013e3181b11648.


Purpose: To compare the effects of Viscofresh 0.5% (carmellose sodium 0. 5%) versus Lubristil (sodium hyaluronate 0.15%) in dry eye syndrome and to study the influence of these two treatments on the expression of various inflammatory markers by flow cytometry in impression cytology specimens.

Methods: In this randomized, masked-observer, parallel group, single-center study, 15 patients with dry eye syndrome were randomized to sodium carmellose 0.5% or sodium hyaluronate 0.15% 1-month treatment after a 1-week washout period. Corneal staining with flurescein, breakup time, Schirmer 1 test with anesthesia (Jones test), and tear clearance were assessed. Besides, conjunctival impression cytology was performed to investigate inflammatory markers (CD3, CD11b, and HLA-DR) using flow cytometry.

Results: Carmellose group shows statistical improvement compared with the hyaluronate group in breakup time, corneal staining, and HLA-DR. The two other inflammatory markers had also a tendency for a decreased expression in both groups, with no statistical significance. There were neither visual acuity loss nor other complications related to treatment.

Conclusion: Both artificial tears improve dry eye signs and symptoms and inflammatory markers expression, with significant better results in carmellose group.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Biomarkers / metabolism*
  • CD11b Antigen / metabolism
  • CD3 Complex / metabolism
  • Carboxymethylcellulose Sodium / administration & dosage*
  • Cornea / drug effects
  • Cornea / metabolism
  • Double-Blind Method
  • Dry Eye Syndromes / drug therapy*
  • Dry Eye Syndromes / metabolism
  • Female
  • Flow Cytometry
  • Fluorescein / metabolism
  • HLA-DR Antigens / metabolism
  • Humans
  • Hyaluronic Acid / administration & dosage*
  • Middle Aged
  • Ophthalmic Solutions / administration & dosage*
  • Prognosis
  • Staining and Labeling / methods
  • Tears / chemistry


  • Biomarkers
  • CD11b Antigen
  • CD3 Complex
  • HLA-DR Antigens
  • ITGAM protein, human
  • Ophthalmic Solutions
  • Hyaluronic Acid
  • Carboxymethylcellulose Sodium
  • Fluorescein