[Comparative study of treatment of the dry eye syndrome due to disturbances of the tear film lipid layer with lipid-containing tear substitutes].
BACKGROUND
A deficiency in the tear film lipid layer is aetiological in about 80 % of the patients suffering from dry eye, which results in excessive evaporation (so-called hyperevaporative dry eye). The treatment with conventional artificial tears did not prove to be successful here. In this study the treatment with two tear substitutes containing lipids were set in contrast with each other.


METHODS
The randomised, controlled, multicentre cross-over study included 74 patients suffering from dry eye caused by a deficiency of the tear film lipid layer, which were organised into two groups. Group A (n = 38) was treated for the first 6 weeks with a liposomal eye spray (Tears Again), while the patients of the group of B (n = 36) were treated with an eye gel containing triglycerides (Liposic) in the same period. After 6 weeks the crossover was performed. The patients were treated in the following 6 weeks with the product which was not used before. Control examinations by masked examiners took place at the beginning of the study as well as after 6 and 12 weeks, considering the following parameters: eyelid edge-parallel conjunctival folds (LIPCOF), BREAK UP time (BUT), Schimer-I test, measurement of the tear meniscus, investigation of the edges of eyelid and visual acuity. In addition. the subjective feelings of the patients were also determined by means of questionnaires.


RESULTS
At the beginning of the study the two groups did not differ significantly with respect to the initial values. After the first treatment period the improvement of the examined parameters LIPCOF, BUT, Schirmer, visual acuity and inflammation of the lid margin in group A (eye spray) proved to be significantly superior in comparison to group B (eye gel). The results of the second treatment period after the crossover were similar and showed an analogous supremacy of the liposomal eye spray. The interviews with the patients revealed that the subjective evaluation concerning efficacy and compatibility of the eye spray turned out to be explicitly more favourable than that concerning the eye gel. 74.6 % of the patients favoured the application as an eye spray onto the closed eyelids over the eye gel into the conjunctival sac. 62.5 % of the patients rated the liposomal eye spray to be better all in all, 12.5 % rated that both preparations are equal and 25 % favoured the eye gel.


CONCLUSIONS
The treatment with phospholipids liposomes shows statistically significant clinical advantages and proves to be favourably and explicitly superior compared to the conventional standard treatment all in all.
Dausch
D
D
Abteilung Augenheilkunde, Klinikum St. Marien, Amberg. burgl.dausch@web.de
Lee
S
S
Dausch
S
S
Kim
J C
JC
Schwert
G
G
Michelson
W
W
D000328:Adult; D000336:Aerosols; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005782:Gels; D006801:Humans; D008081:Liposomes; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage*; D017060:Patient Satisfaction; D010743:Phospholipids / Q000008:administration & dosage*; D011446:Prospective Studies; D014280:Triglycerides / Q000008:administration & dosage*; D014792:Visual Acuity / Q000187:drug effects; D014985:Xerophthalmia / Q000188:drug therapy* / Q000209:etiology
D000336:Aerosols; D005782:Gels; D008081:Liposomes; D009883:Ophthalmic Solutions; D010743:Phospholipids; D014280:Triglycerides