Effect of Diquafosol Tetrasodium Eye Drop for Persistent Dry Eye After Laser In Situ Keratomileusis

Mori, Yosai; Nejima, Ryohei; Masuda, Ayami; Maruyama, Yoko; Minami, Keiichiro; Amano, Shiro

doi:10.1097/ico.0000000000000136

Cited by 36 publications

(23 citation statements)

References 27 publications

(24 reference statements)

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“…We prescribe 0.3% hyaluronic acid 5 times a day for 1 month and 0.1% hyaluronic acid or saline-based lubricants thereafter. 47 Recently, we 48 and others 49 found that a 3% diquafosol tetrasodium ophthalmic solution (DIQUAS ophthalmic solution 3%, Santen Pharmaceutical Co. Ltd. Osaka, Japan), a purinergic P2Y 2 receptor agonist, which stimulates water and mucin secretion from conjunctival epithelial cells and goblet cells, 50 is effective for post-LASIK dry eye. Another mucin supplement, rebamipide (MUCOSTA, Otsuka, Tokyo, Japan), is effective at stabilizing the precorneal tear film and protecting the ocular surface.…”

Section: Tear Supplementsmentioning

confidence: 99%

Dry Eye After LASIK

Toda

2018

Invest. Ophthalmol. Vis. Sci.

114

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Post-LASIK dry eye is the most common postoperative dry eye after ophthalmic surgeries. The clinical signs of post-LASIK dry eye include positive vital staining of the ocular surface, decreased tear breakup time and Schirmer test values, reduced corneal sensitivity, and decreased functional visual acuity. The symptoms and signs usually last for about 1 month after LASIK. A small number of patients continue to experience symptoms more than 1 year postoperatively. It has been suggested that the loss of corneal innervation caused by flapmaking is the major cause, affecting the corneal-lacrimal gland, corneal-blinking, and blinkingmeibomian gland reflexes, resulting in decreased aqueous and lipid tear secretion and mucin expression. A new type of corneal refractive surgery, SMILE, which has less impact on corneal nerves, induces less postoperative dry eye, supporting the association between corneal denervation and postoperative dry eye. As LASIK enhancement by flap-lifting induces fewer dry eye symptoms and signs than initial surgery, factors other than neurotrophic effects may be involved in the mechanisms of post-LASIK dry eye. Post-LASIK ocular surface pain is a type of postoperative chronic pain and discomfort, and is thought to be a different clinical entity from dry eye, possibly induced by abnormal reinnervation or neural sensitization of peripheral nerves and the central nervous system after LASIK. Treatments include tear supplements, anti-inflammatory agents, meibomian gland dysfunction management, ointment and eye patches, punctal plugs, and autologous serum eye drops. For patients with preoperative dry eye, careful patient selection, and preoperative ocular surface management are mandatory.

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Section: Tear Supplementsmentioning

confidence: 99%

Dry Eye After LASIK

Toda

2018

Invest. Ophthalmol. Vis. Sci.

114

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“…Diquafosol stimulates both fluid secretion from the conjunctival epithelial cells and mucin secretion from the conjunctival goblet cells . Recent studies reported that the combination therapy with diquafosol tetrasodium and sodium hyaluronate could be helpful to stabilise the visual performance and to improve subjective dry eye symptoms after LASIK …”

Section: Treatmentmentioning

confidence: 99%

Recent advances in laser in situ keratomileusis‐associated dry eye

Xie

2016

Clinical and Experimental Optometry

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Dry eye is the most common complication after laser in situ keratomileusis (LASIK). The major cause of LASIK-associated dry eye is corneal nerve damage. Early identification and treatment of post-operative dry eye are essential to prevent further ocular surface damage. This article reviews the recent studies of LASIK-associated dry eye, including clinical features, aetiology, risk factors, evaluations and treatment. The applications of novel technologies in LASIK-associated dry eye evaluation like anterior segment spectral-domain optical coherence tomography (SD-OCT) and corneal confocal microscopy are also introduced in this review.

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“…Diquafosol stimulates both fluid secretion from the conjunctival epithelial cells and mucin secretion from the conjunctival goblet cells directly on the ocular surface, thereby rehydrating the ocular surface independent of tear film secretion from the lacrimal glands. [16][17][18] The clinical efficacy of diquafosol for treating dry eye has been reported in recent articles [19][20][21][22][23][24][25][26][27] ; however, its effect in eyes with CLs is not clear. Yokoi et al 28 have reported an increase in tear fluid volume induced by diquafosol in normal eyes.…”

mentioning

confidence: 95%