Short-term adjunctive use of a liposomal tear substitute after repeated intravitreal therapy: a randomized pilot study

PURPOSE: This pilot study investigates the efficacy of a liposomal ophthalmic solution containing cross-linked hyaluronic acid, trehalose, and stearylamine in reducing the occurrence of dry eye-like signs and symptoms in patients undergoing repeated intravitreal treatment. METHODS: Participants aged over 50 years old were randomly assigned to receive either standard therapy alone (Group 1) or standard therapy with additional eye drops (Group 2). Examinations included TBUT, Schirmer's test, fluorescein staining, the Ocular Surface Disease Index (OSDI), and the 5-item Dry Eye Questionnaire (DEQ-5) at baseline and day 15, with a 30-day telephone follow-up for OSDI reassessment. RESULTS: Ninety patients with age-related macular degeneration or other retinal diseases requiring anti-VEGF (vascular endothelial growth factor) treatment were enrolled in the study. In Group 1, which comprised 20 males and 25 females, DEQ-5 scores did not exhibit any significant change between V0 and V1 (10.89 ± 2.71 to 10.57 ± 2.60, p = 0.173), while Group 2, composed of 18 males and 27 females, demonstrated a considerable reduction in DEQ-5 values (9.28 ± 3.24 to 8.00 ± 3.64, p < 0.0001). OSDI scores in Group 1 showed no relevant change between V0 and V1 (p = 0.497), whereas in Group 2 they improved significantly (p < 0.0001). Additionally, Group 2 had notable enhancements in TBUT and Schirmer tests (p < 0.0001), while Group 1 experienced a significant decrease in TBUT values alone (p = 0.026). CONCLUSION: Chronic intravitreal therapy contributes to significant ocular surface impairment, which can be effectively mitigated by the administration of a tear substitute alongside the standard treatment.