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Background   Dry eye disease (DED) is one of the most common complications following refractive surgery.Purpose   Evaluate the efficacy of an osmoprotective eye drop (Optive®) for the management of induced DED in refractive surgery patients.Design   Double-masked randomised controlled trial.Methods   Twenty-two refractive surgery patients oriented to apply FreshTears (FT;  n  = 13) or Optive (Op;  n  = 9), topically, QID, for 3 months. Eye exams were performed before surgery (T0) and 1-month (T1) and 3-month (T3) follow-up and consisted of tear film osmolarity, Schirmer 1 test, tear film breakup time (TBUT), fluorescein staining, and ocular surface disease index (OSDI) and patient symptoms questionnaires.Main Outcome Measures   Pain and osmolarity.Results   Pain increased significantly for FT at T3 ( p  < 0.05). A reduction in osmolarity was observed at T1 and T3 for Op group ( p  < 0.01) and at T3 for FT group ( p  < 0.05). TBUT showed a decrease between T0 and T1 for FT ( p  < 0.05). Schirmer 1 values increased significantly for Op in T1.Conclusions   Op was superior to FT in regard to pain, osmolarity, TBUT, and Schirmer 1. Osmoprotectant solutes, such as L-carnitine, could attenuate inflammation and secondary DED. Osmoprotective lubricants can be effectively applied for the prevention of refractive surgery-related dry eye symptoms and signs.

Topical Osmoprotectant for the Management of Postrefractive Surgery-Induced Dry Eye Symptoms: A Randomised Controlled Double-Blind Trial