Objectives To assess the therapeutic efficacy and safety of preservative-free lubricants versus preserved lubricant drops in managing moderate to severe dry eye disease. Background Dry eye syndrome is a complex condition that affects the stability of the tear film and ocular surface. It leads to discomfort, visual problems, and can significantly compromise the quality of life. Patients and methods A prospective randomized study was conducted on a cohort of patients with moderate to severe dry eye disease. Patients were divided into two groups: group A received preserved eye drops, while group B received preservative-free eye drops. Clinical assessment was performed before and after a 3-month treatment period. The main outcomes included changes in Ocular Surface Disease Index scores, tear production (Schirmer test), tear film stability (tear breakup time), tear meniscus height, lipid layer quality, and meibomian gland function. Results The preservative-free group demonstrated significantly greater improvement across all evaluated parameters compared to the preserved group. Ocular Surface Disease Index scores in the preservative-free group showed a substantial reduction, reflecting better symptomatic relief. Schirmer test values and tear breakup time improved significantly in the preservative-free group, indicating enhanced tear production and tear film stability. Tear meniscus height and lipid layer thickness also showed more pronounced improvements in the preservative-free group, supporting better ocular hydration and reduced evaporation. Meibomian gland function was observed to be better in the preservative-free group, with less gland obstruction and improved lipid secretion compared to preserved-containing lubricant group. Conclusion Preservative-free lubricant eye drops provide better management of moderate to severe dry eye than preserved-containing lubricants by reducing toxicity, stabilizing the tear film, and supporting meibomian gland function, making them ideal for long-term use.
Mandour et al. (Thu,) studied this question.