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Subject Area

Ophthalmology

Article Type

Original Study

Abstract

Background The tear film is a complex mix of electrolytes, proteins (lipocalins, lactoferrin, transferrin, defensin, and lysozyme), phospholipids, oligopeptides, glycopeptides, and immunoglobulins. Objective The aim was to investigate the efficacy of topical carbomer-based lipid-containing artificial tears and hyaluronate in patients with dry-eye disease (DED) based on serum 25-hydroxy vitamin D (25HD) levels and cholecalciferol (vitamin D) supplementation. Patients and methods A nonrandomized clinical trial study was conducted on 42 patients with DED by Schirmer tear-secretion test (mm) who were examined by Ophthalmology Department, Menoufia University Hospital, Egypt, during the study period from March 2020 to March 2021. Results Serum 25HD levels were significantly decreased among vitamin D deficiency (VDD) group than non-VDD group at baseline and after 2 weeks of treatment. International Ocular Surface Disease Index grade was significantly increased among the VDD group after 2 weeks and 4 months of treatment as compare with non-VDD group (P < 0.05). Tear break-up time was significantly decreased among VDD group than non-VDD group after 4 months of treatment (P = 0.015). Lid hyperemia was significantly increased among the VDD group (2.00 ± 0.853) than non-VDD group (1.29 ± 0.659) after 4 months of treatment (P = 0.029). While Schirmer tear-secretion test was significantly decreased among the VDD group (5.75 ± 1.603) than non-VDD group (7.18 ± 1.188) after 2 weeks of treatment (P = 0.009). While Schirmer tear-secretion test did not show any significant difference between the VDD group (6.50 ± 1.567) and non-VDD group (7.75 ± 2.066) after 4 months of treatment. Conclusion The effect of topical topical carbomer-based lipid-containing artificial tears and hyaluronate was dependent on serum 25HD levels. Cholecalciferol supplementation enhanced the efficacy of topical treatment and may be a useful adjuvant therapy for patients with DED refractory to topical lubricants.

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