<p>Acupuncture and dry eye: current perspectives. A double-blinded randomized controlled trial and review of the literature</p>

Abstract

Purpose: Dry eye disease (DED) is a common disorder that negatively impacts quality of life and vision. Prior studies have shown some benefit of acupuncture for dry eye, but very few have included control group to mitigate placebo effect. This study was designed with a sham acupuncture control group to evaluate true acupuncture treatment effect. Methods: This is a prospective, randomized, double-blinded, sham-acupuncture-controlled trial. Acupuncture treatment for dry eye was performed as per the Niemtzow Protocol. Twenty-four patients received true acupuncture and twenty-five received sham acupuncture. Treatment efficacy was assessed by the Ocular Surface Disease Index (OSDI) Questionnaire, ocular surface staining, tear flow, tear film break-up time (TBUT), and a general questionnaire. Atmospheric data were collected to control for the effect of atmospheric conditions on symptoms of dry eye. Results: OSDI scores in the treatment group improved compared to baseline (1 week, p <0.01, 1 month p <0.05, 3 months p <0.05, and 6 months p <0.01). OSDI scores in the control group improved, but did not reach significance ( p =0.09). Secondary outcome measures showed no significant improvement in TBUT, Schiermer’s Test, ocular surface grading, or artificial tear application. However, at 3 months, a significant reduction in the frequency of eye closing was observed among participants receiving true acupuncture treatment when compared to baseline ( p =0.002). Furthermore, intragroup analysis showed significant reduction in symptoms of discomfort ( p =0.01), dryness ( p =0.001), scratchiness ( p =0.001), and redness ( p =0.01) in the true acupuncture group at 3 months. Conclusion: Both true and sham acupuncture improved OSDI at 1 week after treatment, however, the improvement in OSDI was significantly greater in the true treatment groups than the sham group at 6 months after acupuncture. True acupuncture treatment improved many subjective assessments of dry eye symptoms, however, other common indicators used to objectively assess dry eye (tear flow, corneal staining, TBUT) remained unchanged. While there were trends towards improvement in the sham acupuncture group, this did not reach statistical significant during the study period. This suggests a true treatment effect of acupuncture rather than a placebo effect. Acupuncture can, therefore, be an effective adjunct to routine clinical treatment of dry eye.

Laser Acupuncture Improves Tear Film Stability in Patients with Dry Eye Disease: A Two-Center Randomized-Controlled Trial

“…Nonetheless, there was no significant improvement in the TFBUT or Schirmer-I test, compared with conventional treatment. 28 Despite needle acupuncture not being more effective than artificial tears in improving ocular symptoms during the 4-week treatment, it may have benefits on the midterm outcomes of DED. 12 When combined with artificial tear treatment, needle acupuncture had a weaker effect on TFBUT.…”

Ocular Surface Pain: A Narrative Review

“…The active treatment group (baseline OSDI 34 ± 17) demonstrated significant improvements in symptoms at 1 week (19 ± 17; p < 0.01), 1 month (21 ± 17; p < 0.05), 3 months (20 ± 21; p < 0.05), and 6 months (16 ± 12; p < 0.01). Improvements were also noted in the sham group, although to a smaller degree, from a baseline OSDI of 36 ± 20 to lower scores at 1 week (24 ± 22), 1 month (24 ± 21), 3 months (21 ± 20), and 6 months (25 ± 18) [ 116 ]. Further data regarding the efficacy of acupuncture in the treatment of ocular surface pain areneeded, given its use in treating other neuropathic pain conditions [ 37 , 117 ].…”

Acupuncture for the treatment of dry eye

“…[ 24 ] However, another study suggests that true AC was superior to sham AC for reducing DE symptoms. [ 25 ] To our knowledge, no meta-analysis has been performed to ascertain whether true AC is superior to placebo AC for DE treatment. Therefore, we perform this systematic review to provide evidence from RCTs to assess the effectiveness and safety of AC for treating DE.…”