Comparison of Hypotonic and Isotonic Solutions Containing Sodium Hyaluronate on the Symptomatic Treatment of Dry Eye Patients

Comparison of Hypotonic and Isotonic Solutions Containing Sodium Hyaluronate on the Symptomatic Treatment of Dry Eye Patients. A Prospective, Randomized, Multicentral, Clinical trial.

Article specifications

This clinical trial was published in 2001 in Journal of ophthalmologica (IF 2015:3.032) by Italian ophthalmologists. The aim of this study was to compare the efficacy of 2 hyaluronic acid artificial tear with different osmolarity in dry eye syndrome. 139 patients with dry eye syndrome were divided in 2 groups: first group including 78 patients were treated with isotonic and then hypotonic hyaluronic acid eyedrop, and the other group including 61 patients treated with hypotonic and then isotonic hyaluronic acid eyedrop. Every patient were examined before treatment and 28, 35 ,63 days during the treatments, Their examination included tear BUT (mean of 2 different measurements), fluorescein staining, rose Bengal staining (at least 5 min after fluorescein staining) and a Schirmer II test with anesthetic (Jones test).

Results

In this study they found no significant different between isotonic and hypotonic solution in treatment of dry eye. All the experience had same outcome except the BUT witch was better improve by the hypotonic solution. In conclusion although an increased tear osmolarity has been found in dry eye patients and it has been considered toxic for the corneal epithelium, the use of hypotonic eyedrops as a remedy for hyperosmolarity does not offer a significant advantage with respect to an isotonic solution. Our study suggests that in designing new tear substitutes, attention should not be focused on tear diluents to compensate the hypertonicity associated with the dry eye status. One possible attempt should duplicate the tear film.