Use of a combination preparation based on medium-chain triglycerides for the treatment of dry eye syndrome

Background Dry eye syndrome (DES) is a common disorder that significantly affects the quality of life of patients [1]. Impaired lipid layer of the tear film leads to increased evaporation of tear fluid. In particular, patients with type 2 diabetes mellitus (T2DM) are at higher risk of developing DES due to changes in lipid metabolism and dysfunction of the meibomian glands (MG) [2]. New treatments are aimed at restoring the lipid layer of the tear film. A tear substitute containing medium-chain triglycerides (MCT) reduces evaporation and improves the condition of the ocular surface [3, 4]. Objective To study the effect of a drug with MCT on stabilization of the lipid layer of the tear film and clinical manifestations of DES in patients, including those with T2DM. Material and methods A single-center, non-randomized, controlled study was conducted involving 27 patients divided into two groups: Group 1 (DES and T2DM, n = 12) and Group 2 (DES without T2DM, n = 15). Patients received artificial tears with SC-TG 4 times a day for 1 month. Efficacy assessment included the OSDI questionnaire, Schirmer I test, Norn test, corneal fluorescein staining, meibum mass spectrometry analysis, and tiascopy. Results Mass spectrometry revealed a decrease in triglyceride and cholesterol levels in all patients, especially in patients with T2DM. After a month of therapy, the degree of corneal staining decreased to 1 point in 94% of patients in the first group, while no significant changes were observed in the second group. Thiascopy showed that the improvement of the lipid layer was more pronounced in patients with type 2 diabetes. The use of a drug with MCTG and carbomer contributed to the improvement of functional parameters in patients with type 2 diabetes (p < 0.05) compared with the baseline data. Conclusion The use of a drug containing MCTG helps to stabilize the lipid layer of the tear film, reduce the severity of subjective complaints and improve clinical parameters in patients with dry eye syndrome. The effect is especially significant in patients with type 2 diabetes, who have more pronounced lipid metabolism disorders in the mammary gland. Further studies may confirm the need for long-term use of such drugs to maintain the stability of the lipid layer and improve the condition of the ocular surface. Key words: dry eye syndrome; medium-chain triglycerides; meibomian glands; tear film; mass spectrometric analysis