Department of Ophthalmology, Tokyo Dental College, Ichikawa General Hospital, Chiba, Japan.
Cornea. 2013 Aug;32(8):1120-5. doi: 10.1097/ICO.0b013e3182930b1d.
To investigate the effects of diquafosol sodium (DQS) eye drops, a purinergic P2Y2 receptor agonist, on tear film stability in patients with unstable tear film (UTF).
Two prospective studies were conducted. One was an exploratory nonrandomized trial on 39 eyes with dry eye symptoms and short tear film break-up time (BUT), but without epithelial damage. Changes in symptoms, BUT, Schirmer value, and ocular surface fluorescein staining (FS) scores were studied for 3 months. The other was a randomized clinical trial of DQS and artificial tears (AT) in 17 eyes with short BUT. Eyes with decreased Schirmer values (≤ 5 mm) were excluded. Changes in symptoms, BUT, FS scores, and tear film stability using continuous corneal topographic analysis were studied for 4 weeks.
In the exploratory study, while Schirmer values were not significantly increased, significant improvements in symptoms and BUT were noted at both 1 and 3 months. In the randomized clinical trial, significant improvements in symptoms were noted in the DQS group, but not in the AT group, at 2 weeks. BUT was significantly prolonged in the DQS group at 4 weeks but not in the AT group. No significant changes were noted in FS scores or tear film stability.
DQS improved subjective symptoms and prolonged BUT in eyes with UTF not associated with low tear secretion and ocular surface epithelial damage. Because many patients who have UTF are refractory to conventional treatments, DQS may offer benefits in the treatment of dry eyes.
研究二磷酸鸟苷(DQS)滴眼剂(一种嘌呤能 P2Y2 受体激动剂)对不稳定泪膜(UTF)患者泪膜稳定性的影响。
进行了两项前瞻性研究。一项是对 39 只具有干眼症状和短泪膜破裂时间(BUT)但无上皮损伤的眼睛进行的探索性非随机试验。研究了 3 个月内症状、BUT、Schirmer 值和眼表面荧光素染色(FS)评分的变化。另一项是对 17 只 BUT 短的 DQS 和人工泪液(AT)的随机临床试验。排除 Schirmer 值降低(≤5mm)的眼睛。研究了 4 周内症状、BUT、FS 评分和使用连续角膜地形分析的泪膜稳定性的变化。
在探索性研究中,虽然 Schirmer 值没有显著增加,但在 1 个月和 3 个月时,症状和 BUT 均有显著改善。在随机临床试验中,DQS 组在 2 周时症状明显改善,但 AT 组无明显改善。DQS 组在 4 周时 BUT 显著延长,但 AT 组无显著延长。FS 评分或泪膜稳定性无明显变化。
DQS 改善了 UTF 不伴有低泪液分泌和眼表面上皮损伤的眼睛的主观症状和延长了 BUT。由于许多 UTF 患者对常规治疗反应不佳,DQS 可能在干眼症的治疗中具有益处。