Efficacy of Sodium Hyaluronate and Carboxymethylcellulose in Treating Mild to Moderate Dry Eye Disease

Abstract

The efficacies of SH and CMC were equivalent in treating mild to moderate dry eye. SH and CMC preservative-free artificial tear formulations appropriately manage dry eye sign and symptoms and show safety and efficacy when frequently administered in a unit dose formula.

Can the optimum artificial tear treatment for dry eye disease be predicted from presenting signs and symptoms?

“…A significant improvement in comfort [3,41], TBUT [3], NaFl corneal staining [3] and Schirmer's test [40] has been reported following CMC dry eye treatment, which was similar to the improvement attained following sodium hyaluronate treatment, as found by the current study. Additionally, TheraTears also has a patented hypotonic electrolyte balance that reduces elevated tear osmolarity, [42] reversing the osmotic gradient and ensuring the tear film hydrates the ocular surface and prevents ocular tissue dessication.…”

“…Sodium hyaluronate increases tear film stability by increasing tear film viscosity between blinks [2]. Clinical trials of sodium hyaluronate dry eye treatment have reported an increase in ocular comfort [1][2][3][4]15], a reduction in NaFl corneal staining [3], a reduction in Rose Bengal staining [28], an increase in NITBUT [2,4], an increase in Schirmer's score [29] and an improvement in impression cytology grading [16]. Sodium hyaluronate is a naturally occurring glycosaminoglycan of the extracellular matrix and a ligand for the hyaluronate receptor CD44 [30].…”

“…Numerous compositions of dry eye treatments are commercially available, principally differing in which element of the tear film they primarily aim to replace. Sodium hyaluronate is a glycosaminoglycan with viscoelastic properties 2 that increases tear film stability [2][3][4] and increases epithelial cell migration [5][6]. Carboxymethylcellulose (CMC) is an anionic cellulose polymer with a carboxylic group, which exhibits a high affinity for bioadhesion [7], increases tear film stability 3 and increases epithelial cell migration [8].…”

“…Sodium hyaluronate is a glycosaminoglycan with viscoelastic properties 2 that increases tear film stability [2][3][4] and increases epithelial cell migration [5][6]. Carboxymethylcellulose (CMC) is an anionic cellulose polymer with a carboxylic group, which exhibits a high affinity for bioadhesion [7], increases tear film stability 3 and increases epithelial cell migration [8]. Liposomal dry eye treatments consist of phospholipids, which enhance the lipid tear film layer [9] and also increase tear film stability [9][10][11].…”

Effect of Viscous Agents on Corneal Density in Dry Eye Disease

“…13 Numerous investigations have focused on the effectiveness and safety of ocular lubricants in animal models and clinical trials. 14,15 However, little is known on the effect of ocular lubricants on corneal morphology in vivo. We have recently demonstrated that corneal density and thickness decreases in dry eye patients in an age-dependent manner.…”