title: Successful tear lipid layer treatment for refractory dry eye in office workers by low-dose lipid application on the full-length eyelid margin.
abstract: OBJECTIVE
  To test tear lipid layer treatment by low-dose lipid application on the full-length eyelid margin for the treatment of office workers with dry eyes refractory to conventional treatments.
  
  
  METHODS
  Prospective interventional case series.
  
  
  METHODS
  Thirty eyes of 30 office workers with dry eyes with dark tear interference images, which did not respond to conventional treatments, were included. To supply lipid using a commercially available nonpreserved topical medication having both polar and nonpolar lipid base, ofloxacin eye ointment (Santen Pharmaceutical, Osaka, Japan) was selected. Low-dose ofloxacin ointment application on the full-length eyelid margin was carried out three times a day for two weeks. The symptom of ocular dryness using a visual analog scale, tear interferometry to assess lipid layer thickness (LLT), corneal fluorescein staining, tear-film breakup time (BUT), and meibum expressibility gradings were compared.
  
  
  RESULTS
  After the treatment, the symptom score of ocular dryness decreased from 91.4 +/- 11.9 to 33.6 +/- 21.0 (P < .0001), LLT increased from 39 +/- 4 nm to 161 +/- 91 nm (P < .0001), BUT was prolonged from 2.6 +/- 1.6 seconds to 4.8 +/- 2.1 seconds (P = .01), and meibum expressibility gradings decreased from 2.8 +/- 1.3 to 1.6 +/- 1.3 (P = .0005).
  
  
  CONCLUSIONS
  For office workers with refractory dry eyes, tear lipid layer treatment by low-dose ointment applied on the full-length eyelid margin was shown to be an effective approach. The applied lipid formed a uniform lipid layer, which contributed to tear stability, leading to the improvement of the symptom.
authors.affiliation: Department of Ophthalmology, School of Dental Medicine, Tsurumi University, Yokohama, Japan. goto-e@tsurumi-u.ac.jp
authors.forename: Eiki
authors.initials: E
authors.lastname: Goto
authors.forename: Murat
authors.initials: M
authors.lastname: Dogru
authors.forename: Kazumi
authors.initials: K
authors.lastname: Fukagawa
authors.forename: Miki
authors.initials: M
authors.lastname: Uchino
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Matsumoto
authors.forename: Megumi
authors.initials: M
authors.lastname: Saiki
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
mesh_terms: D000328:Adult; D015352:Dry Eye Syndromes / Q000188:drug therapy*; D005143:Eyelids / Q000187:drug effects*; D005260:Female; D006801:Humans; D007368:Interferometry; D008027:Light; D008055:Lipids / Q000008:administration & dosage*; D008297:Male; D009790:Occupations; D009824:Ointments / Q000008:administration & dosage; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D011446:Prospective Studies; D013666:Tears / Q000737:chemistry
chemical_list: D008055:Lipids; D009824:Ointments; D009883:Ophthalmic Solutions