Combination therapy with diquafosol tetrasodium and sodium hyaluronate in patients with dry eye after laser in situ keratomileusis

Am J Ophthalmol. 2014 Mar;157(3):616-22.e1. doi: 10.1016/j.ajo.2013.11.017. Epub 2013 Nov 27.

Abstract

Purpose: To evaluate the possible advantages of combination therapy with diquafosol tetrasodium and sodium hyaluronate for dry eye after laser in situ keratomileusis (LASIK).

Design: Prospective randomized comparative trial.

Methods: A total of 206 eyes of 105 patients who underwent LASIK were enrolled in this study. Patients were randomly assigned to 1 of 4 treatment groups according to the postoperative treatment: artificial tears, sodium hyaluronate, diquafosol tetrasodium, and a combination of hyaluronate and diquafosol. Questionnaire responses reflecting subjective dry eye symptoms, uncorrected and corrected visual acuity, functional visual acuity, manifest refraction, tear break-up time, fluorescein corneal staining, Schirmer test, and corneal sensitivity were examined before and 1 week and 1 month after LASIK.

Results: Distance uncorrected visual acuity was significantly better in the combination group than in the hyaluronate group 1 week and 1 month after LASIK. Near uncorrected visual acuity was significantly better in the combination group than in the artificial tear and diquafosol groups 1 week and 1 month after LASIK. Distance functional visual acuity improved significantly only in the combination group 1 month after LASIK. The Schirmer value in the combination group was significantly higher than that in the hyaluronate group at 1 month after LASIK. Subjective dry eye symptoms in the combination group improved significantly compared with those in the other groups 1 week after surgery.

Conclusions: Our results suggest that hyaluronate and diquafosol combination therapy is beneficial for early stabilization of visual performance and improvement of subjective dry eye symptoms in patients after LASIK.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cornea / physiology
  • Drug Therapy, Combination
  • Dry Eye Syndromes / drug therapy*
  • Dry Eye Syndromes / etiology
  • Dry Eye Syndromes / physiopathology
  • Female
  • Humans
  • Hyaluronic Acid / therapeutic use*
  • Keratomileusis, Laser In Situ / adverse effects*
  • Male
  • Ophthalmic Solutions
  • Polyphosphates / therapeutic use*
  • Prospective Studies
  • Purinergic P2Y Receptor Agonists / therapeutic use*
  • Refraction, Ocular / physiology
  • Surveys and Questionnaires
  • Tears / physiology
  • Uracil Nucleotides / therapeutic use*
  • Viscosupplements / therapeutic use*
  • Visual Acuity / physiology

Substances

  • Ophthalmic Solutions
  • Polyphosphates
  • Purinergic P2Y Receptor Agonists
  • Uracil Nucleotides
  • Viscosupplements
  • diquafosol
  • Hyaluronic Acid