Efficacy of carbomer sodium hyaluronate trehalose vs hyaluronic acid to improve tear film instability and ocular surface discomfort after cataract surgery

Abstract

Purpose

To evaluate the effects of carbomer sodium hyaluronate trehalose (CHT) and sodium hyaluronate eye drops on tear film stability and ocular discomfort after cataract surgery.

Setting

Santa Maria della Misericordia Hospital, Rovigo, Italy.

Design

Prospective randomized case-control study.

Patients and methods

This study enrolled sixty patients scheduled for unilateral cataract surgery. After phacoemulsification, subjects received carbomer sodium hyaluronate trehalose (trehalose group) or sodium hyaluronate tears (HG group) substitute and were assessed through objective (break up time, corneal and conjunctival staining) and subjective (OSDI questionnaire) clinical evaluations after a two times a day topical administration. Outcome measures were collected preoperatively (baseline), one week (day 7) and 1 month (day 30) after surgery. Finally, each patient was asked to give his personal treatment satisfaction score.

Results

Trehalose group showed a steeper break up time (BUT) increase compared to patient treated with hyaluronic acid (P<0.001). OSDI questionnaire presented a opposite trend, trehalose patients evidenced a significantly major improvement (P<0.001), and in seven days mean values reduced by more than three times. Fluorescein staining reduction was documented with both treatments, although there was no statistically significant difference between groups. Finally CHT resulted in a significantly greater global satisfaction score (P<0.001).

Conclusions

CHT was effective and well tolerated in reducing dry eye disease symptoms and improving the clinical outcome after cataract surgery. On some parameters (BUT, OSDI), this new formulation was more effective than commonly used sodium hyaluronate in treating ocular irritation and tear film alterations.

Keywords:

• cataract surgery
• tear film instability
• artificial tears
• trehalose

What was known

• Cataract surgery can have a negative impact even on the ocular surface of an apparently healthy individual, leading to a short-term tear film instability and eye irritation.

• Trehalose and hyaluronic acid was proven to be an effective combination of two active ingredients for the treatment of dry eye symptoms; however, number of administration and patient compliance are still a major challenge.

What this paper adds

• Carbomer sodium hyaluronate trehalose is a novel artificial tear preparation that seems to be effective in reducing ocular irritation and tear film dysfunction even with a short number of daily administrations

• To our knowledge, no other studies regarding safety and efficacy of this new formulation have been published.

Synopsis

Carbomer sodium hyaluronate trehalose administered two times a day after cataract surgery showed a statistically significant higher improvement in tear film stability and ocular discomfort compared to hyaluronic acid solution.

Disclosure

The authors report no conflicts of interest in this work.