Abstract

Purpose
This study aimed to evaluate the therapeutic effects of 3% diquafosol tetrasodium ophthalmic solution (Diquas) and a carbomer-based, lipid-containing eye gel (Liposic, Bausch & Lomb) in dry eye patients with lid wiper epitheliopathy (LWE) that was refractory to topical treatment with conventional artificial tears.
Methods
Thirty-three dry eye patients with LWE of the upper eyelid were treated with 3% diquafosol ophthalmic solution administered six times daily and a carbomer-based, lipid-containing eye gel administered four times daily. After the 2-week treatment period, changes in ocular symptoms were assessed using a visual analog scale (VAS), and changes in ocular signs were evaluated using tear film break-up time (TBUT), corneal staining, and LWE grading.
Results
The mean patient age was 37.58±12.35 years (range, 21–67 years); six patients were male and 27 were female. At baseline, the mean VAS symptom score was 7.18±1.47, and the mean TBUT was 2.78±0.78 seconds. After 2 weeks of treatment, the mean VAS score decreased to 4.87±1.97, and the mean TBUT increased to 3.68±1.08 seconds (both P<0.05). The mean corneal staining score was 1.09±1.50, and the mean LWE grade was 5.76±0.61 at baseline. Following treatment, these values decreased to 0.55±0.83 and 2.24±1.95, respectively (both P<0.05). Among the objective parameters, only the LWE grade showed a significant correlation with the VAS score.
Conclusion
The LWE grade showed a significant correlation with ocular symptoms. Combined treatment with diquafosol ophthalmic solution and a carbomer-based, lipid-containing eye gel demonstrated excellent therapeutic effects in dry eye patients with LWE who were refractory to treatment with conventional artificial tears.

• Keywords: Lid wiper epitheliopathy, Friction, Blinking, Mucin secretagogue