Comparison of 2% Rebamipide Monotherapy and 0.15% Hyaluronic Acid Combination Therapy for Dry Eye after Cataract Surgery

Purpose: To compare the effects of 2% rebamipide eye drop monotherapy versus in combination with 0.15% hyaluronic acid eye drops on dry eye syndrome following cataract surgery.Methods: One week post-cataract surgery, patients with dry eye syndrome were randomly assigned to receive either rebamipide monotherapy or a combination therapy with hyaluronic acid. Evaluations were conducted at 1 week, 1 month, and 2 months postoperatively, including strip meniscometry, tear breakup time, conjunctival and corneal staining, tear meniscus height, tear lipid layer thickness, and the ocular surface disease index.Results: In the rebamipide monotherapy group, significant improvements in tear breakup time were observed at 1 month (<i>p</i> = 0.049) and 2 months (<i>p</i> < 0.001) post-surgery, with additional improvements in ocular surface staining (<i>p</i> = 0.010) and ocular surface disease index (<i>p</i> = 0.007) at 2 months. In the combination therapy group, significant improvements in tear breakup time and staining were observed at both 1 and 2 months (tear breakup time: <i>p</i> < 0.001, < 0.001; staining: <i>p</i> = 0.001, < 0.001, respectively). However, strip meniscometry and ocular surface disease index scores worsened at 2 months (<i>p</i> = 0.004, 0.012, respectively). Compared to the rebamipide-only group, the combination group demonstrated higher tear breakup time, lower tear meniscus height, a higher ocular surface disease index score, and reduced corneal lipid layer thickness at 1 month (<i>p</i> = 0.014, 0.028, 0.004, 0.043, respectively). By 2 months, the combination group exhibited lower strip meniscometry scores and a higher ocular surface disease index (<i>p</i> = 0.001, < 0.001).Conclusions: The combined use of rebamipide and hyaluronic acid eye drops after cataract surgery showed benefits for dry eye syndrome, particularly with improvements in tear breakup time and corneal staining.