Researchers examined the effectiveness of topical carbomer-based lipid-containing artificial tears (CLAT) and hyaluronate (HU) in patients with dry eye disease.
Study design
The cohort comprised 116 dry eye patients, who were divided into 2 groups based on whether they had deficient or nondeficient serum vitamin D levels. All patients, regardless of their vitamin D levels, were offered the choice of no supplementation, oral supplementation or intramuscular supplementation.
Ocular Surface Disease Index (OSDI) score, visual analog pain scale score (VAPS), lid hyperemia, tear breakup time (TBUT), corneal fluorescein staining score and Schirmer test were evaluated at baseline and 2 weeks following treatment.
Outcomes
The use of CLAT and HU topical therapy improved OSDI and VAPS scores in both the deficient and nondeficient groups, However, TBUT, corneal fluorescein staining score and lid hyperemia were improved only in the nondeficient group.
Additionally, OSDI, TBUT and lid margin hyperemia were improved in patients injected intramuscularly with 200,000 IU cholecalciferol, but not in patients given oral or no supplements.
Limitations
The retrospective nature of the study makes control of treatment compliance especially difficult for topical and oral administration of medications. The number of patients who elected for oral supplementation of vitamin D was much smaller than those who elected for intramuscular injection.
Clinical significance
The findings suggest the effect of topical lubricants (CLAT and HU) depends on serum vitamin D levels, and that vitamin D may act synergistically with topical treatments to harmonize components of the tear film. Vitamin D supplementation by the intramuscular route may enhance the efficacy of topical dry eye treatments, and can possibly be used as potential adjuvant therapy for patients with dry eye disease.