Comparative evaluation of effi cacy and safety of carboxymethylcellulose either alone or in combination with non-steroidal anti-infl ammatory drug in the treatment of dry eye in a tertiary care teaching hospital.

ABSTRACT

Background: Dry eye produces discomfort and reduced vision. The treatment of dry eyes has traditionally involved hydrating and lubricating artifi cial tears. The newer medications include non-steroidal anti-infl ammatory drugs (NSAIDs) for the treatment of dry eye disorders. This study was designed to compare the effect of topical carboxymethylcellulose (CMC) alone or in combination with topical NSAID for the treatment of dry eye in a tertiary care teaching hospital. Methods: A total of 60 patients diagnosed with dry eye were enrolled for a study period of 1 year. Patient of either sex (male/female), age between 18 and 70 years, and all diagnosed cases of dry eye in ophthalmology outpatient department were selected. Patients (n=60) were stabilized on CMC for 2 weeks and thereafter divided into two groups. Group I (n=30) received only topical CMC; Group II (n=30) received CMC+NSAID. The patients were followed up to 12 weeks. Diagnostic tests included Schirmer’s test and tear break up time (TBUT). Ocular Surface Disease Index (OSDI) was used for assessing the Quality of Life. Analysis was done using GraphPad InStat software. p<0.05 was considered signifi cant. Results: This was an open-label study revealing a mean age of 46.0±1.79 years. Females (56.67%) showed a signifi cantly higher prevalence of dry eye symptoms compared to males (43.33%). The mean duration of illness was 1.95±0.16 years. Schirmer’s test, TBUT test values and OSDI score in Group I and Group II at 0 and 12 weeks revealed signifi cant intragroup difference (p<0.0001). At 12 weeks intergroup comparison in Schirmer’s test value (p>0.05) and TBUT test value (p>0.05) showed no signifi cant difference while OSDI score revealed signifi cant difference (p<0.05). Burning, stinging, blurring of vision, photophobia, and hyperemia were among the common adverse effects seen. Conclusion: Both groups showed signifi cant improvement in Schirmer’s test and TBUT test value and OSDI score at the end of the study. Intergroup comparison showed a signifi cant difference with reference to OSDI score. Patients receiving NSAID reported more adverse effects.