Efficacy, safety, and tolerability of pharmacological treatments for moderate-to-severe dry eye disease: systematic review of randomized controlled trials

Authors

  • Carolyn Yu Tung Wong +852 5326 3232
  • Justin Man Kit Tong Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China

Keywords:

Cyclosporine, Dry eye syndromes, Hyaluronic acid, Lifitegrast, Ophthalmic solutions

Abstract

Dry eye disease (DED) is characterized by impaired tear film homeostasis and ocular surface inflammation. Topical ocular medications for moderate-to-severe DED include hyaluronic acid (HA), cyclosporine A (CsA), serum eyedrops (SE), and lifitegrast. Effective HA-based formulations and regimens include topical aqueous HA 0.15% and 0.18%, HA gel 0.30%, sequential administration of HA 0.30% and 0.15%, a combination of HA 0.15% and polyethylene glycol, and multi-agent eyedrops containing 0.15% HA. Preservative-free hydrocortisone and loteprednol, known as soft steroids, are effective and have a reduced risk of steroid-related adverse effects. Effective CsA formulations include 0.05% CsA gel, CsA nanoemulsions, water-free CsA, and CsA combinations with lubricants (eg, HA). Autologous, allogeneic, and umbilical cord serum eyedrops, as well as the novel lymphocyte function-associated antigen-1 antagonist lifitegrast, are also effective. Various treatment options may improve treatment adherence. Long-term and large-scale studies are required to confirm the therapeutic efficacies of these treatments.

 

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Published

2024-05-09

How to Cite

1.
Wong CYT, Tong JMK. Efficacy, safety, and tolerability of pharmacological treatments for moderate-to-severe dry eye disease: systematic review of randomized controlled trials. Hong Kong J Ophthalmol [Internet]. 2024May9 [cited 2024May21];28(1). Available from: https://hkjo.hk/index.php/hkjo/article/view/383

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