Clinical Effects of Combination Therapy Using Heparin and Phospholipid in Severe Dry Eye Syndrome

ABSTRACT

PURPOSE: To evaluate the therapeutic effects of topical heparin (Hylo-Parin(R), Ursapharm Saarbr cken, Germany) and spray type phospholipids (Tears Again(R), Optima Pharmazeutische GmbH. Freising, Germany) in severe dry eye syndrome resistant to conventional therapy. METHODS: Twenty eyes of ten patients with refractory severe dry eye were treated with Hylo-Parin(R) (two times a day) and Tears Again(R) (three times a day) for three months. Before and one and three months after treatment, a symptom questionnaire was administered to the patients. The ocular surface disease index (OSDI), tear film break-up time, Schirmer test, conjunctival fluorescein staining examinations and filamentary keratitis were evaluated. RESULTS: After using Tears Again(R) and Hylo-Parin(R), the OSDI score improved from 64.13 +/- 15.12 to 43.80 +/- 15.87 (p<0.01). Tear film break-up time significantly increased from 1.0 +/- 0.65 to 2.3 +/- 0.73 seconds (p<0.01) and conjunctival staining score (Oxford scale) significantly decreased from 3.85 +/- 0.75 to 3.25 +/- 0.97 (p<0.01). Filamentary keratitis in the slit-lamp examination showed significant improvement (p<0.01). CONCLUSIONS: Tears Again(R) and Hylo-Parin(R) are considered as new treatment modalities for severe dry eye syndrome and filamentary keratitis in patients with chronic ocular surface disease resistant to conventional therapy. These treatments require additional research.