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Review
, 8, 1419-33
eCollection

Artificial Tears Potpourri: A Literature Review

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Review

Artificial Tears Potpourri: A Literature Review

Majid Moshirfar et al. Clin Ophthalmol.

Abstract

Numerous brands and types of artificial tears are available on the market for the treatment of dysfunctional tear syndrome. Past literature has focused on comparing the components of these products on patient's clinical improvement. The wide array of products on the market presents challenges to both clinicians and patients when trying to choose between available tear replacement therapies. Different formulations affect patients based on etiology and severity of disease. In order to provide an unbiased comparison between available tear replacement therapies, we conducted a literature review of existing studies and National Institutes of Health clinical trials on commercially available, brand name artificial tears. Outcomes evaluated in each study, as well as the percent of patients showing clinical and symptomatic improvement, were analyzed. Fifty-one studies evaluating different brands of artificial tears, and their efficacy were identified. Out of the 51 studies, 18 were comparison studies testing brand name artificial tears directly against each other. Nearly all formulations of artificial tears provided significant benefit to patients with dysfunctional tear syndrome, but some proved superior to others. From the study data, a recommended treatment flowchart was derived.

Keywords: Blink®; CMC; GenTeal®; HPMC; Lacrisert®; Refresh®; Sjogren’s Syndrome; Soothe®; Systane®; TBUT; artificial tears; dry eye; dysfunctional tear syndrome; lipid layer; liquid polyols; ocular surface inflammatory disease; ophthalmic lubricant; polyvinyl alcohol; tear film; tear osmolarity.

Figures

Figure 1
Figure 1
Treatment flowchart. Notes: aContains 0.3% HPMC and 0.25% CMC; bPreservative-free option available; cPreservative-free option: Refresh Plus®. Manufacturers are as follows: Refresh®, Allergan, Irvine, CA, USA; GenTeal®, Novartis Pharmaceuticals, East Hanover, NJ, USA; Lacril®, Allergan; Blink®, Abbott Laboratories Inc., Abbott Park, IL, USA; Systane®, Alcon Laboratories, Inc.; Soothe®, Bausch & Lomb Incorporated, Bridgewater, NJ, USA; Viscotears®, Novartis Pharmaceuticals; Liposic®, Bausch & Lomb Incorporated; Tears Again®, OcuSoft, Rosenberg, TX, USA. Abbreviations: CMC, carboxy methylcellulose; DTS, dysfunctional tear syndrome; HPMC, hydroxypropyl methylcellulose; PEG, polyethylene glycol; PG, propylene glycol.

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