The effect of an artificial tear combining hyaluronic acid and tamarind seeds polysaccharide in patients with moderate dry eye syndrome: a new treatment for dry eye

Eur J Ophthalmol. 2014 Mar-Apr;24(2):173-8. doi: 10.5301/ejo.5000355. Epub 2013 Sep 9.


Purpose: Synergistic interactions between hyaluronic acid (HA) and tamarind seed polysaccharide (TS-polysaccharide) have been demonstrated by means of nuclear magnetic resonance spectroscopy. This study was designed to investigate the potential clinical benefit of a combination of HA and TS-polysaccharide in managing dry eye disease (DED).

Methods: A total of 49 subjects with moderate DED, confirmed by Ocular Surface Disease Index (OSDI) questionnaire score between 10 and 25, tear break-up time (BUT) <10 seconds, or Schirmer I test <5.5 mm after 5 minutes, and lissamine green staining of the ocular surface >2 according to National Eye Institute score system, were enrolled into this multicenter, randomized, double-masked study to receive either combination of HA and TS-polysaccharide or carmellose sodium for 3 months, both instilled 4 times per day. The assessments included OSDI questionnaire, tear film stability (BUT), tear production (Schirmer I test), and corneal and conjunctival staining.

Results: Patients treated with HA and TS-polysaccharide showed a statistically significant improvement in the OSDI score at the end of the study compared to the baseline and control groups. The HA and TS-polysaccharide and carmellose sodium were equally effective in reducing BUT and the extent of injury assessed by corneal and conjunctival staining. Non-significant changes were recorded for Schirmer I test.

Conclusions: Based on the results of this clinical trial, the combination of HA and TS-polysaccharide appears to be effective in improving the symptoms of dry eye, opening new scenarios in possible treatment of the disease by combining different molecules.

Publication types

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

MeSH terms

  • Conjunctiva / physiopathology
  • Cornea / physiopathology
  • Double-Blind Method
  • Drug Therapy, Combination
  • Dry Eye Syndromes / drug therapy*
  • Dry Eye Syndromes / physiopathology
  • Female
  • Humans
  • Hyaluronic Acid / therapeutic use*
  • Male
  • Middle Aged
  • Ophthalmic Solutions*
  • Phytotherapy*
  • Polysaccharides / therapeutic use*
  • Seeds / chemistry*
  • Surveys and Questionnaires
  • Tamarindus / chemistry*
  • Tears / physiology


  • Ophthalmic Solutions
  • Polysaccharides
  • Hyaluronic Acid