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The effect of preservative free hydrocortisone 0.335% eye drops on tear film thickness in patients with moderate to severe dry eye disease
Author(s) -
Schmidl Doreen,
Kallab Martin,
Hommer Nikolaus,
Szegedi Stephan,
Stegmann Hannes,
Werkmeister René,
Schmetterer Leopold,
Garhofer Gerhard
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2019.5126
Subject(s) - medicine , ophthalmology , intraocular pressure , artificial tears , hydrocortisone , surgery
Purpose Dry Eye Disease (DED) has been found to be associated with reduced pre‐corneal tear film thickness (TFT). Previous studies have shown that topical lubricants have the potential to increase TFT in patients with DED. In the present study, we investigated whether anti‐inflammatory therapy with topical low dose preservative free (PF) soft steroid, hydrocortisone 0.335% eye drops also has an effect on TFT in patients with moderate to severe DED. Methods A total of 60 patients with moderate to severe DED were included. Patients were randomized to receive either hydrocortisone 0.335% for 12 days 4 times daily followed by 2 days twice daily instillation (intense treatment group) or 8 days 3 times daily followed by 3 days twice daily treatment (recommended treatment group). TFT was assessed using a custom‐built ultra‐high resolution optical coherence tomography system at baseline, at day 14 and day 28. Measurement of intraocular pressure (IOP) and standard clinical tests to assess signs and symptoms of DED, such as the Ocular Surface Disease Index (OSDI), were performed. Results Four weeks after treatment start, a significant increase in TFT was observed in both groups (5.3 ± 8.9%, p = 0.03 vs. baseline in the intense and 5.6 ± 13.1%, p = 0.04 vs. baseline in the recommended treatment group) with no difference between the two groups (p = 0.94). IOP did not change at the end of the treatment period in neither of the two treatment groups (p = 0.38, from 14.1 ± 1.8 to 13.9 ± 2.0 mmHg in the intense and from 12.8 ± 1.9 to 13.3 ± 2.1 mmHg in the standard treatment group). OSDI significantly decreased from baseline during the study period in both study groups (p < 0.001, by 19.5 ± 39.1% and 24.1 ± 33.9%, respectively) after PF hydrocortisone treatment. Conclusions The present data show that low dose hydrocortisone PF eye drops have the potential to restore TFT in patients with moderate to severe DED. This indicates that this anti‐inflammatory therapy option acts directly in the disease process.