Evaluating the prophylactic action of lipid and non-lipid containing tear supplements in a simulated adverse environment

Evaluating the prophylactic action of lipid and non-lipid containing tear supplements in a simulated adverse environment: A randomised crossover trial


Jennifer P Craig, Anjay Marasini, Alex Münts, Michael TM Wang


Purpose: Purpose: To evaluate the prophylactic action of lipid and non-lipid containing artificial tear supplements in a simulated adverse environment.

Method: Methods: Twenty-eight participants with symptomatic dry eye (57 % female, with mean age ± standard deviation of 29 ± 9 years) were recruited in a prospective, double-blinded, randomised crossover trial. On separate days, participants were randomised to single application of a nanoemulsion tear lipid supplement (Systane® Complete, Alcon) to one eye, and a non-lipid containing eye drop (Systane® Ultra, Alcon) to the contralateral eye. Participants were then exposed to a previously validated simulated adverse environment (moving air at a speed of 3.2 ms-1, generated by a standing fan placed 1m from the eyes, for 2.5 minutes). SANDE symptom score, non-invasive tear film breakup time, lipid layer grade, and tear meniscus height were assessed at baseline, following tear supplement instillation, and after exposure to the simulated adverse environment, and compared statistically using repeated measures two-way analysis of variance (ANOVA).

Results: Results: Post-instillation, both treatments resulted in clinically meaningful and statistically significant improvements in SANDE symptom score and non-invasive tear film stability (all p<0.05), although increased lipid layer quality was limited to the lipid-containing tear supplement (p=0.003). Although protective effects were observed with both treatments following exposure to the simulated adverse environment, superior SANDE symptom scores, non-invasive tear film stability, and lipid layer quality were observed in the lipid-containing tear supplement group (all p<0.05). No significant changes were observed in tear meniscus height in either treatment group (both p>0.05).

Conclusions: Conclusions: Both the lipid and non-lipid containing artificial tear supplements exhibited prophylactic efficacy against the simulated adverse environment, with the nanoemulsion eye drop most effectively preserving tear film quality and reducing dry eye symptoms.

1st Author Biography: Jennifer Craig is a therapeutic optometrist and associate professor in the Department of Ophthalmology at the University of Auckland, where she heads the Ocular Surface Research Laboratory.  She is widely published with well over 100 peer-reviewed scientific articles and many articles in the professional press.  Jennifer enjoys presenting at research and continuing education conferences, and has received awards in recognition of her teaching and research.  She holds a number of adjunct appointments at reputed institutions across the world and has served on several Tear Film and Ocular Surface Society International Workshops including, most recently, as vice-chair of TFOS DEWS II.

*Data correct at the time of submission to BCLA by NCC.