The clinical use of viscoelastic artificial tears and sodium chloride in dry-eye syndrome

This study was performed to test viscoelastic artificial tears (VAT) based on both subjective and clinical parameters in patients with keratoconjuncti vitis sicca (KCS). Twenty-eight patients were evaluated in a randomized dou ble-blind study. Sodium hyaluronate was used in two different concentration s (0.4%, 0.25%) and in combination with chondroitin sulfate. Each preparati on was used for one week preceded by another weekly cycle using a sodium ch loride solution. Before and after each cycle, clinical examinations were pe rformed: tear film break-up time, Schirmer's test, lipid-layer thickness an d fluorescein staining. Patients kept a record of the drop-frequency, subje ctive response and side effects. After the study, they were asked to give a rating of the various preparations. The severity of KCS was expressed base d on a sicca score and correlated with response to viscoelastic treatment. Both the subjective and the clinical parameters revealed no statistically s ignificant differences between the various viscoelastic agents or between t he viscoelastics and the sodium chloride solutions. Severe side effects did not occur. There was a positive correlation of response to viscoelastic tr eatment with severe KCS (+0.36) but not with mild KCS (-0.07). The VAT seem s to be indicated in severe cases of dry-eye syndrome. Sodium chloride solu tions may be a useful short-term alternative to other tear formulations. (C ) 2001 Elsevier Science Ltd. All rights reserved.