title: Effectiveness of artificial tears in the management of evaporative dry eye.
abstract: OBJECTIVE
  To compare the efficacies of sodium hyaluronate, hydroxypropyl methylcellulose (HPMC), and a new oil-in-water emulsion (Emustil unidose; SIFI) in the management of lipid-deficient dry eye.
  
  
  METHODS
  Seventy-five subjects with dry eye were randomly divided into 3 groups. Each was allocated sodium hyaluronate, HPMC, or emulsion eyedrops to be used four times daily for 90 days. Parameters were measured at baseline, 30 days, and 90 days. A compliance visit was performed at days 7 and 60.
  
  
  RESULTS
  Significant reduction (P < 0.05) in evaporation and improvement in symptoms in all groups were found. No statistically significant increase in tear turnover rate (TTR) was found with any solution. A significant difference in tear stability and noninvasive tear break-up time (NITBUT) was found in the emulsion and sodium hyaluronate groups but not in the HPMC group (P > 0.05). There was a significant decrease in osmolarity and corneal staining in the emulsion group (P < 0.001) but not in the sodium hyaluronate or HPMC group (P > 0.05).
  
  
  CONCLUSIONS
  A significant reduction in evaporation and improvement in symptoms in all therapy groups were found from baseline to 90 days. However, no significant effect was seen on TTR for any group. The emulsion drops were shown to perform best, improving tear stability, and decreasing osmolarity and corneal staining. These results are consistent with improvements in the lipid layer of the tear film as a result of prolonged use of emulsion drops.
authors.affiliation: Department of Vision Sciences, Glasgow Caledonian University, Glasgow, United Kingdom. louise.mccann@gcal.ac.uk
authors.forename: Louise C
authors.initials: LC
authors.lastname: McCann
authors.forename: Alan
authors.initials: A
authors.lastname: Tomlinson
authors.forename: Edward I
authors.initials: EI
authors.lastname: Pearce
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Papa
mesh_terms: D000328:Adult; D015352:Dry Eye Syndromes / Q000188:drug therapy* / Q000378:metabolism; D004655:Emulsions / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use*; D065347:Hypromellose Derivatives; D007368:Interferometry; D008297:Male; D008747:Methylcellulose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D013666:Tears / Q000187:drug effects / Q000502:physiology*
chemical_list: D004655:Emulsions; D009883:Ophthalmic Solutions; D065347:Hypromellose Derivatives; D006820:Hyaluronic Acid; D008747:Methylcellulose