RESUMO
PURPOSE: To evaluate the therapeutic effect of topical testosterone gel application to periocular area in dry eye. METHODS: Thirty-four eyes of 17 patients with refractory dry eye were included. Five patients had Sjogren's syndrome and 12 were non-Sjogren's syndrome patients. Testosterone gel was applied on the periocular area three times a day. Symptom score corneal sensitivity test (CST), tear film break-up time (BUT), basal tear secretion test (BST), fluorescein staining, tear clearance test (TCR), and conjunctival impression cytology were checked and evaluated before, one month after and two months after treatment. RESULTS: The mean symptom score before topical testosterone gel application was 3.44+/-0.70; it was 2.88+/-0.84 at 1 month after application and 2.03+/-1.09 at 2 months after application. The improvement of tear film parameters including BUT, tear clearance rate, fluorescein staining score, conjunctival metaplasia and goblet cell density was statistically significant (P<0.05) at one and two months after treatment but neither BST nor CST was improved with statistically significance. There was no difference in the therapeutic effect of topical testosterone gel between Sjogren's syndrome and non-Sjogren's dry eye patients. CONCLUSIONS: The function of tear film and the integrity of ocular surface improved after topical application of testosterone gel in dry eye patients. Topical testosterone gel application may be an effective adjuvant therapy for the treatment of dry eye.