title: Fluorescein-tear breakup time as an assessment of efficacy of tear replacement therapy in dry eye patients: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To review outcomes of studies where fluorescein-tear breakup time (fTBUT) measurements had been made before and after treatment with artificial tears.
  
  
  METHODS
  Peer-reviewed articles were identified that reported average values for fTBUT before and after approximately 1 month of treatment of dry eye with aqueous-based artificial tears. 48 data sets were used for calculating the net (percentage) change in fTBUT, with 21 including information of variability (as reported SD of average value) of the fTBUT data suitable for a meta-analysis.
  
  
  RESULTS
  Prior to treatment, average fTBUT values ranged from 0.9 s to 11.8 s (group mean 4.7 +/- 1.7 s, n = 48 data sets). After treatment, these values ranged from 2.2 to 10.7 s (group mean 6.1 +/- 2.3 s; P<.001), with net increase for the treatment effect being 1.4 +/- 1.2 s (range - 1.4 to + 4.5 s). Similar changes were reported regardless of the type of product type. The meta-analysis confirmed a net effect at 1.3 s, with the magnitude of the variability (as a weighted SE) having a similar overall value of 1.1 s.
  
  
  CONCLUSIONS
  Following use of 'artificial tears' by dry eye patients, a small but predictable increase in tear film stability has generally been reported, the net magnitude of which is close to a 33% improvement.
authors.affiliation: Department of Vision Sciences, Glasgow-Caledonian University, Glasgow, UK. Electronic address: m.doughty@gcal.ac.uk.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Doughty
mesh_terms: D015352:Dry Eye Syndromes / Q000175:diagnosis* / Q000188:drug therapy*; D019793:Fluorescein; D006801:Humans; D065346:Lubricant Eye Drops / Q000627:therapeutic use*; D013666:Tears
chemical_list: D065346:Lubricant Eye Drops; D019793:Fluorescein
keywords: artificial tears; dry eye; fluorescein tear breakup time (fTBUT); meta-analysis; systematic review