Categorization of Marketed Artificial Tear Formulations Based on Their Ingredients: A Rational Approach for Their Use

Dry eye disease is a common ocular condition affecting millions of people worldwide. Artificial tears are the first line therapy for the management of dry eye disease. Artificial tear formulations contain a variety of active ingredients, biologically active excipients, and preservatives. Many of these formulations are also available as preservative-free. This study was conducted to inspect artificial tear formulations currently marketed in the United States for their active ingredients, biologically relevant excipients, and preservatives. The marketed artificial tears were examined at various US retail pharmacy chains and using the manufacturers’ website to compile information about active ingredients, inactive ingredients, and preservatives. The currently marketed artificial tears can be grouped into four categories based on their active ingredients. The artificial tears also contain biologically active chemicals listed as inactive ingredients, which have osmoprotectant, humectant, and tear film lipid layer or mucous layer mimicking properties. Most artificial tears contain vanishing type preservatives such as purite or sodium perborate and safer quaternary compound polyquaternium-1. The majority of these artificial tear formulations are also available as preservative-free single dose unit. The study provides a formulary of artificial tears based on active ingredients, biologically active excipients, and the preservative-free option. The formulary should assist healthcare providers in making a stepwise and rational selection of appropriate artificial tears for patients suffering from dry eye disease.

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Acupuncture at a Single Acupoint, BL1 (Jingming), Compared to Artificial Tears in Moderate to Severe Dry Eye Disease: A Randomized Controlled Trial

10.21203/rs.3.rs-564123/v1 ◽

2021 ◽

Author(s):

xue zhang ◽

Bo Zhang ◽

Siyang Peng ◽

Guoliang Zhang ◽

Jumei Ma ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Dry Eye ◽

Primary Outcome ◽

Controlled Trial ◽

Dry Eye Disease ◽

Eye Disease ◽

Artificial Tears ◽

Artificial Tear ◽

Randomized Controlled

Abstract BackgroundThe global incidence of dry eye disease (DED) is very high. DED seriously affects the quality of life of patients; however, the current curative effect of medicine for moderate to severe DED is poor. This randomized clinical trial was planned to investigate the effect of acupuncture compared with artificial tears on moderate to severe DED.MethodsA randomized clinical trial was performed at 2 hospitals in China. 120 DED patients were randomly equally divided into an acupuncture and an artificial tear group. Either acupuncture or artificial tears was performed for an 8-week period, and a 32-week follow-up was performed. The primary outcome measure was the Schirmer-I test (SIT) value. The secondary outcome measures included the numerical rating scale (NRS) for improvement in ocular symptoms, the ocular surface disease index (OSDI), the tear-film break-up time (TBUT), corneal fluorescein staining (CFS), and acupuncture acceptability. Adverse events also were monitored and documented.ResultsFor the primary outcome, the mean changes in the SIT values were significantly different between the acupuncture (5.75 [2.53‒9.75]) and artificial tear (0.52 [-1.18‒2.46]) groups at week 8 (P = 0.01). The OSDI decreased by -16.14 (-35.40‒16.30) and − 7.65 (-19.25‒15.05) from baseline to week 8 in the acupuncture and artificial tear groups, respectively (P < 0.05). A significant decrease was found in the NRS score for eye dryness, eye pain, and blurred vision in the acupuncture group, as compared to the artificial tear group. However, the change in the average symptom NRS score, TBUT, and CFS did not differ significantly at week 8. Five cases experienced acupuncture-related adverse events.ConclusionsThis randomized clinical trial found that acupuncture at a single acupoint, BL1, significantly promoted tear secretion and improved multiple eye discomfort symptoms. Acupuncture showed greater benefits than artificial tears for moderate to severe DED. However, the study findings warrant verification.Trial registrationRegistration number: ChiCTR1800015831. Name of trial registry: Efficacy and safety of acupuncture in the treatment of moderate to severe dry eye disease: a randomized controlled trial.

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Safety and Efficacy of a Preservative-Free Artificial Tear Containing Carboxymethylcellulose and Hyaluronic Acid for Dry Eye Disease: A Randomized, Controlled, Multicenter 3-Month Study

Clinical Ophthalmology ◽

10.2147/opth.s256480 ◽

2020 ◽

Vol Volume 14 ◽

pp. 2951-2963

Author(s):

Pasquale Aragona ◽

Jose M Benítez-del-Castillo ◽

Minas T Coroneo ◽

Subhanjan Mukherji ◽

Jacqueline Tan ◽

...

Keyword(s):

Hyaluronic Acid ◽

Dry Eye ◽

Dry Eye Disease ◽

Eye Disease ◽

Safety And Efficacy ◽

Artificial Tear ◽

Randomized Controlled ◽

Preservative Free

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Real-life results of switching from preserved to preservative-free artificial tears containing hyaluronate in patients with dry eye disease

Clinical Ophthalmology ◽

10.2147/opth.s160053 ◽

2018 ◽

Vol Volume 12 ◽

pp. 1519-1525 ◽

Cited By ~ 5

Author(s):

Linda Nasser ◽

Malgorzata Rozycka ◽

Gabriela Gomez Rendon ◽

Alejandro Navas

Keyword(s):

Dry Eye ◽

Real Life ◽

Dry Eye Disease ◽

Eye Disease ◽

Artificial Tears ◽

Preservative Free

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Lágrimas artificiais no tratamento da doença do olho seco: uma revisão de literatura/ Artificial tears in the treatment of dry eye disease: a literature review

Brazilian Journal of Development ◽

10.34117/bjdv7n7-024 ◽

2021 ◽

Vol 7 (7) ◽

pp. 65512-65533

Author(s):

Rafaela Montenegro Aires Sampaio ◽

Anyssa Brilhante Aires Montenegro ◽

Claudia Roberta de Andrade

Keyword(s):

Literature Review ◽

Dry Eye ◽

Dry Eye Disease ◽

Eye Disease ◽

Artificial Tears

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Efficacy and safety of two new formulations of artificial tears in subjects with dry eye disease: a 3-month, multicenter, active-controlled, randomized trial

Clinical Ophthalmology ◽

10.2147/opth.s78184 ◽

2015 ◽

pp. 665 ◽

Cited By ~ 25

Author(s):

Peter Simmons ◽

Haixia Liu ◽

Cindy Carlisle-Wilcox ◽

Joseph Vehige

Keyword(s):

Randomized Trial ◽

Dry Eye ◽

Dry Eye Disease ◽

Eye Disease ◽

Efficacy And Safety ◽

Artificial Tears

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Autologous serum compared to artificial tears for the treatment of dry eye disease

Medicine: Case Reports and Study Protocols ◽

10.1097/md9.0000000000000171 ◽

2021 ◽

Vol 3 (11) ◽

pp. e0171

Author(s):

Ana Karen Pérez-Vázquez ◽

José Gerardo Serrano-Robles ◽

Alejandro Navas ◽

Enrique O. Graue-Hernandez ◽

Arturo Ramírez-Miranda ◽

...

Keyword(s):

Dry Eye ◽

Dry Eye Disease ◽

Autologous Serum ◽

Eye Disease ◽

Artificial Tears

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Crosslinked hyaluronic acid with liposomes and crocin for management symptoms of dry eye disease caused by moderate meibomian gland dysfunction

10.21203/rs.2.17536/v1 ◽

2019 ◽

Author(s):

José-María Sánchez-González ◽

Concepción De-Hita-Cantalejo ◽

María Carmen Sánchez-González

Keyword(s):

Hyaluronic Acid ◽

Dry Eye ◽

Meibomian Gland ◽

Dry Eye Disease ◽

Eye Disease ◽

Schirmer Test ◽

Ocular Surface Disease Index ◽

Artificial Tear ◽

Before And After ◽

Contralateral Eye

Abstract Background: To study the effect of uncrosslinked and crosslinked hyaluronic acid combined with other artificial tear components in patients with dry eye caused by moderate meibomian gland dysfunction.Method: Prospective, single-blind, contralateral eye study. Fifty eyes were analyzed (25 patients). Eye selection for each tear type was random, and the eye drop formulations Aquoral Forte® (artificial tear A) and Aquoral Lipo® (artificial tear B) were used. The determined dosing schedule was three times a day for six weeks, and the study participants underwent a clinical examination before and 45 days after lubricant treatment. The Schirmer test, tear breakup time (TBUT) test, and Ocular Surface Disease Index (OSDI) questionnaire were applied before and after instillation period with both types of artificial tears. Results: On the Schirmer test, a significant improvement was obtained with both tear A (p < 0.01) and tear B (p < 0.01). On the TBUT test, a significant improvement was obtained with tear A (p < 0.01) and tear B (p < 0.01). The OSDI score significantly decreased after instillation period with both artificial tear types (p < 0.01). Conclusion: Uncrosslinked hyaluronic acid combined with other components, such as tamarind seed polysaccharide, and crosslinked hyaluronic acid combined with liposomes and crocin are effective for management symptoms of dry eye disease.

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The effect of tamarind seed polysaccharidecontaining eye drop in dry eye syndrome: Results of an interventional, comparative, clinical study

Medical Hypothesis, Discovery & Innovation in Optometry ◽

10.51329/mehdioptometry128 ◽

2021 ◽

Vol 2 (2) ◽

pp. 71-76

Author(s):

Naser Nozari ◽

Shahrokh Ramin

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Dry Eye Disease ◽

Ocular Surface Disease ◽

Eye Disease ◽

Eye Drops ◽

Artificial Tears ◽

Mean Values ◽

The Mean ◽

Contralateral Eye

Background: The mainstay of dry eye treatment is artificial tear solutions. Contralateral eye comparison of 2 types of artificial tears (Xiloial versus Tearlose) in managing dry eye disease was sought in this study. Methods: This study was a prospective, interventional, contralateral eye comparison of 2 types of artificial tears used for managing dry eye disease. The study participants were categorized into mild (13–22 points), moderate (23–32 points), or severe (33–100 points) ocular surface disease according to the baseline ocular surface disease index (OSDI) questionnaire score. Schirmer I and tear film break-up time (TBUT) tests, as well as detailed slit-lamp examinations, were performed at baseline and at the end of the study. All participants received Xiloial monodose eye drops for the right eye and Tearlose eye drops for the left eye, administered as a single drop 4 times per day. Furthermore, they were instructed to perform lid hygiene every 12 hours per day for both eyes. Results: Thirty-five patients (70 eyes) with a mean ± standard (SD) age of 50.2 ± 13.4 years were included, and 14 (40%) were men. The mean ± SD of the OSDI score was 44.24 ± 22.59 at baseline. Of the 35 patients, 10 (28.6%), 5 (14.3%), and 20 (57.1%) had mild, moderate, and severe ocular surface disease, respectively, according to the baseline OSDI score. Compared to baseline, the mean values of both TBUT and Schirmer I tests improved significantly in both groups (both P < 0.001). In comparing the final mean values between the 2 groups, this improvement was comparable for the Schirmer I test (P = 0.179), but TBUT in Tearlose-instilled eyes improved significantly more than in the fellow eyes (P < 0.001). Conclusions: Both Xiloial and Tearlose eye drops improved tear stability and tear production after a 2 week treatment period in eyes with dry eye disease. This improvement was comparable for tear production, but Tearlose-instilled eyes showed significantly greater improvement in tear stability. Further studies with longer follow-up and larger sample sizes could provide more reliable results as a basis for the clinical use of this TSP-containing lubricant eye drop solution in dry eye disease.

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