Sodium hyaluronate in the treatment of dry eye after cataract surgery: a meta-analysis

Abstract

Background: The incidence of dry eye is high after a cataract surgery. However, the clinical efficacy of sodium hyaluronate combined with conventional eye drops for dry eye after cataract surgery remains unclear.The currently available studies were based on small sample sizes, and no systematic review on this topic has been conducted. Thus, a meta-analysis was performed to systematically and accurately evaluate the clinical value of sodium hyaluronate in the treatment of dry eye after cataract surgery.Methods: English-language databases including PubMed, Cochrane, and Web of Science, and Chineselanguage databases including (CNKI), Wanfang Database, and CQVIP were systematically searched for relevant articles published up to December 31, 2019. The pooled effect size of qualitative data was evaluated with relative risk (RR) and 95% confidence interval (CI), and the overall effect of the quantitative data was estimated by using weighted mean difference (WMD) or standard mean difference (SMD) and 95% CI.Randomized controlled clinical trials concerning the use of sodium hyaluronate combined with conventional treatment for dry eye after cataract surgery were included. The quality of the included literature was evaluated by RevMan5.3 software, and the rest of the statistical data were analyzed using the "meta" package of the R3.5.1 software.Results: A total of 24 articles including 2,177 eyes (1,088 eyes in the combination group and 1089 eyes in the control group) were included. Twelve articles reported the total effective rate after 1 month of treatment (I 2 =71%), and the random effects model was used to estimate RR. The total effective rate in the combination group was 1.33 times that of the control group (95% CI: 1.21, 1.47). Ten articles reported the dry eye symptom score after 1 month of treatment (I 2 =92%). The SMD was estimated using the random effects model. The dry eye symptom score in the combination group was significantly lower than that in the control group, with an SMD of −2.98 (95% CI: −3.69, −2.27). Seventeen articles reported the tear film break-up time (BUT) after 1 month of treatment. As shown in the random effects model, BUT was significantly longer in the combination group than in the control group, with an MD of 2.06 (95% CI: 1.63, 2.49). Sixteen articles described the scores of a fluorescein (FL) eye stain test after 1 month of treatment. As shown in the random effects model, FL score was significantly lower in the combination group than in the control group, with an SMD of −2.52 (95% CI: −3.23, −1.81). Eight articles reported the results of Schirmer I test (SIt) after 1 month of treatment. As estimated by the random effects model, the wetting length in SIt was significantly higher in the combination group than in the control group, with an MD of 1.50 (95% CI: 0.53, 2.48). In the elderly population, BUT was significantly higher in the combined group than in the control group, with an MD of 2.97 (95%CI: 2.47, 3.47); however, the FL score and SIt showed no such significant difference. Conclusions:...

Clinical Efficacy of an Eyedrop Containing Hyaluronic Acid and Ginkgo Biloba in the Management of Dry Eye Disease Induced by Cataract Surgery

“…A recent meta-analysis quantified the amelioration of TBUT after a 1-month treatment with HA to ∼2.0 s (95% confidence interval, 1.63–2.49 s). 16 In our study, the mean change occurring between day 1 and week 4 in HA-GB was higher (2.7 s). The higher success of our study may be explained by the inclusion of patients with less severe ocular surface damage compared with other studies or with an extra benefit owing to the beneficial properties of GB in DED management (thanks to the antioxidant and anti-inflammatory properties, GB promotes normal tear secretion; moreover it also promotes axonal regrowth and reduces postoperative pain).…”

“…It is possible that similar results in our study could be obtained also with other lubricating eyedrops. HA alone is in fact effective in reducing epithelial damage and improving TBUT after cataract surgery, 16 and we previously showed a beneficial effect after cataract surgery also using a combination of hypromellose and coenzyme Q10 17 and a combination of liposomes, omega 3, vitamin D and vitamin A palmitate 18 ; also diquafosol 19 ; and lifitegrast 20 ; showed beneficial effects.…”

Effect of Recombinant Human Epidermal Growth Factor Associated with Conventional Drug Therapy on the Dry Eye Symptom Score in Patients with Dry Eyes after Cataract Surgery: A Systematic Review and Meta-Analysis

“…The main component of sodium hyaluronate eye drops is sodium hyaluronate, which is a mucopolysaccharide [ 9 ]. It binds to fibronectin to promote epithelial cell attachment and extension.…”

“…There are many kinds of artificial tears, among which sodium hyaluronate is the most used because of its good viscosity and ductility [ 8 ]. The anti-inflammatory effect of sodium hyaluronate can also relieve local irritation on the ocular surface [ 9 , 10 ]. rhEGF has been shown to enhance the quantity of convoluted goblet cells in patients suffering from dry eye, which successfully facilitates the growth and differentiation of tear film and epithelial structures of the cornea, reducing corneal epithelial damage, promoting changes in tear film quality, and alleviating dry eye signs [ 11 ].…”

Sodium hyaluronate combined with rhEGF contributes to alleviate clinical symptoms and Inflammation in patients with Xerophthalmia after cataract surgery

“…Artificial tear is the most direct and minimally invasive treatment. Sodium hyaluronate, as an artificial tear, has been widely adopted in the treatment of xerophthalmia in recent decades [ 13 ]. Sodium hyaluronate has an obvious effect on ameliorating the symptoms of postoperative xerophthalmia, but its effect on alleviating inflammation is poor [ 14 ].…”