Comparison of Rebamipide Clear Solution and Diquafosol Eyedrops in Dry Eye Disease with Short Tear Break-up Time: A Retrospective, Comparative Observational Study

PURPOSE: To compare the efficacy of 2% rebamipide clear solution and 3% diquafosol eyedrops in dry eye disease (DED) patients with short tear break-up time (tBUT). METHODS: This nonrandomized retrospective, comparative observational study included 120 eyes (60 patients) divided into Group 1 (2% rebamipide, 60 eyes) and Group 2 (3% diquafosol, 60 eyes). Evaluations at baseline, 1 month, and 3 months included Ocular Surface Disease Index Questionnaire (OSDI), Schirmer I, noninvasive tBUT (NItBUT), corneal/conjunctival staining score, meiboscore, meibum expressibility and quality, lipid thickness, tear meniscus height (TMH), impression cytology, and goblet cell density. The primary endpoint was NItBUT change at 3 months. RESULTS: = 0.014). CONCLUSION: In patients with short tBUT DED, both rebamipide clear solution and diquafosol eyedrops showed comparable improvement in the primary endpoint, NItBUT at 3 months, as well as in other ocular surface parameters. Under standard dosing regimens, however, diquafosol was associated with greater increases in Schirmer I test values and TMH than rebamipide clear solution.