Early results on the use of chitosan-N-acetylcysteine (Lacrimera®) in the management of dry eye disease of varied etiology

Int Ophthalmol. 2019 Mar;39(3):693-696. doi: 10.1007/s10792-018-0843-0. Epub 2018 Mar 16.

Abstract

Purpose: To evaluate the effect of once daily administration of chitosan-N-acetylcysteine (Lacrimera®) in the management of dry eye disease (DED).

Methods: Eighteen patients (3 male, 15 female) aged 25-86 years (mean 61.1) and suffering from moderate to severe DED with superficial punctate keratitis (SPK) were retrospectively evaluated after a trial of Lacrimera® drops (1 drop in the morning for 5 days only). All the patients were using other artificial tears before the treatment. All lubricants were stopped, and Lacrimera® was started instead. Slit-lamp examination and images were taken before and at 1 and 3 weeks follow-up after the treatment. The subjective (Ocular Surface Disease Index, OSDI) and objective (Oxford Grading System, OGS) evaluation was recorded. A paired student's t test was performed to analyse the data.

Results: At baseline, the SPK grade was I to IV (OGS) and the OSDI ranged from 25 to 71.4. Fifteen patients showed a statistically significant (p < 0.0001) improvement in OGS and the OSDI at 3 weeks post-treatment. Three patients showed no improvement.

Conclusions: A single-dose instillation of chitosan-N-acetylcysteine for five consecutive days improved signs and symptoms in patients affected from DED from a variety of causes, who were refractory to standard treatment with lubricants. Given its posology, the absence of side effects and the results obtained Lacrimera® should be taken into consideration as a viable option in patients with moderate to severe DED.

Keywords: Artificial drops; Dry eyes disease; Management; Symptoms.

Publication types

  • Case Reports

MeSH terms

  • Acetylcysteine / administration & dosage*
  • Adult
  • Aged
  • Aged, 80 and over
  • Chitosan / administration & dosage
  • Chitosan / analogs & derivatives*
  • Dry Eye Syndromes / diagnosis
  • Dry Eye Syndromes / drug therapy*
  • Dry Eye Syndromes / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Keratitis / complications*
  • Keratitis / diagnosis
  • Keratitis / drug therapy
  • Lubricant Eye Drops
  • Male
  • Middle Aged
  • Ophthalmic Solutions
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Substances

  • Lubricant Eye Drops
  • Ophthalmic Solutions
  • chitosan-N-acetylcysteine conjugate
  • Chitosan
  • Acetylcysteine