Effect of Viscous Agents on Corneal Density in Dry Eye Disease

J Ocul Pharmacol Ther. 2015 Oct;31(8):504-8. doi: 10.1089/jop.2014.0157. Epub 2015 Jun 23.


Purpose: To investigate the effect of the viscous agents, hydroxypropyl methylcellulose (HPMC), carbomer, povidone, and a combination of HPMC and povidone on corneal density in patients with dry eye disease.

Methods: In total, 98 eyes of 49 patients suffering from dry eye and 65 eyes of 33 healthy age-matched individuals were included in this prospective, randomized study. Corneal morphology was documented with Scheimpflug photography and corneal density was analyzed in 5 anatomical layers (epithelium, bowman membrane, stroma, descemet's membrane, and endothelium). Corneal density was evaluated for the active ingredients HPMC, carbomer, povidone, and a combination of HPMC and povidone as the viscous agents contained in the artificial tear formulations used by the dry eye patients. Data were compared to the age-matched healthy control group without medication.

Results: Corneal density in dry eye patients was reduced in all 5 anatomical layers compared to controls. Corneal density was highest and very close to control in patients treated with HPMC containing ocular lubricants. Patients treated with lubricants, including carbomer as the viscous agent displayed a significant reduction of corneal density in layers 1 and 2 compared to control.

Conclusion: HPMC containing ocular lubricants can help to maintain physiological corneal density and may be beneficial in the treatment of dry eye disease.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acrylic Resins / pharmacology*
  • Aged
  • Case-Control Studies
  • Cornea / drug effects*
  • Cornea / physiology
  • Corneal Pachymetry / methods
  • Corneal Topography / methods
  • Dry Eye Syndromes / drug therapy*
  • Dry Eye Syndromes / physiopathology
  • Female
  • Humans
  • Hypromellose Derivatives / pharmacology*
  • Lubricant Eye Drops / pharmacology*
  • Male
  • Povidone / pharmacology*
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Reproducibility of Results
  • Viscosity / drug effects*


  • Acrylic Resins
  • Lubricant Eye Drops
  • carbomer
  • Hypromellose Derivatives
  • Povidone