Efficacy of polyethylene glycol–propylene glycol-based lubricant eye drops in reducing squamous metaplasia in patients with dry eye disease

Figures & data

Table 1 Nelson’s grading system for impression cytology

Gradea	Goblet cells characteristics	Epithelial cells characteristics
0	Normal density	Normal cells
I	Decreased density	Reduced nucleocytoplasmic ratio (1:3 ratio)
II	Absence of cells	Larger cells with a nucleocytoplasmic ratio of 1:4 to 1:5
III	Absence of cells plus squamous metaplasia	Cells with a large eosinophilic cytoplasm with folded edges and pyknotic nuclei (nucleocytoplasmic ratio of more than 1:6)

Notes:

a A combination of grades (eg, Grade I–II, Grade II–III, Grade I–III, and so on) can be present at the same time in the cytological sample of a patient. When improving, the cellular changes progress following the same pattern (Grade III pass to Grade II, Grade II pass to Grade I, and Grade I pass to Grade 0), in the same sample from the same patient.

Figure 1 Representative PAS-and H and E-stained images at 400× magnification showing (A) a normal number and morphology of goblet cells (Grade 0) (B) squamous metaplasia (Grade 3).

Figure 2 Mean conjunctival impression cytology scores (ie, mean goblet cell density) at baseline and Days 30, 60, and 90 after treatment with PEG-PG/HP-guar artificial tears.

Notes: *P-value for mean change in scores vs baseline. ^$The lower the scores, the greater the improvement.
Abbreviations: PEG-PG/HP-guar, polyethylene glycol–propylene glycol/hydroxypropyl-guar; SD, standard deviation.

Figure 3 Conjunctival impression cytology grades of eyes at (A) baseline and (B) 90 days after treatment with PEG-PG/HP-guar artificial tears.

Abbreviations: OD, oculus dextrus (right eye); OS, oculus sinister (left eye); PEG-PG/HP-guar, polyethylene glycol–propylene glycol/hydroxypropyl-guar.

Figure 4 The mean corneal staining sum score at baseline and Days 30, 60, and 90 after treatment with PEG-PG/HP-guar artificial tears.

Notes: *P-value for mean change in scores vs baseline. ^$The lower the scores, the greater the improvement.
Abbreviations: PEG-PG/HP-guar, polyethylene glycol–propylene glycol/hydroxypropyl-guar; SD, standard deviation.

Figure 5 The mean conjunctival staining score at baseline and Days 30, 60, and 90 after treatment with PEG-PG/HP-guar artificial tears.

Notes: *P-value for mean change in scores vs baseline. ^$The lower the scores, the greater the improvement.
Abbreviations: PEG-PG/HP-guar, polyethylene glycol–propylene glycol/hydroxypropyl-guar; SD, standard deviation.

Figure 6 Mean TFBUT at baseline and Days 30, 60, and 90 after treatment with PEG-PG/HP-guar artificial tears.

Notes: *P-value for mean change in scores vs baseline. Dashed lines indicate the inclusion criterion at baseline (TFBUT <7 s).
Abbreviations: PEG-PG/HP-guar, polyethylene glycol–propylene glycol/hydroxypropyl-guar; SD, standard deviation; TFBUT, tear film break-up time.