Effects of 3% diquafosol sodium on tear film stability, corneal aberration parameters, and vision-related quality of life in pediatric orthokeratology-associated dry eye disease

Background This study assessed the efficacy of 3% diquafosol sodium ophthalmic solution (DQS) on tear film stability, corneal aberration parameters, and vision-related quality of life in pediatric orthokeratology (OK)-associated dry eye disease (DED). Methods This prospective, single-arm study recruited patients who wore OK lenses and had DED. All patients received 1 drop of 3% DQS 6 times daily for 4 weeks. The best corrected visual acuity (BCVA), intraocular pressure (IOP), non-invasive tear breakup time (NITBUT), tear meniscus height (TMH), tear film lipid layer (TFLL), higher-order aberrations (HOAs), conjunctivocorneal staining score (CS), Ocular Surface Disease Index (OSDI), and pediatric refractive error profile (PREP-ok) questionnaire were assessed at baseline, at weeks 2, and up to 4 weeks. Results The final analysis included 28 patients (28 eyes) with a mean age of 10.92 ± 1.65 years (57.1% female). 3% DQS significantly improved the overall PREP score, particularly in overall vision, near vision, symptoms, and handling (all p < 0.05). Total HOAs, horizontal coma, and spherical aberration were significantly reduced (all p < 0.05). Tear film stability (NITBUT, TMH) and OSDI scores also improved significantly (all p < 0.05). No significant changes were observed in far vision, appearance, satisfaction, activities, trefoil, tetrafoil, TFLL, and corneal staining. Conclusions Short-term treatment with 3% DQS was associated with improved tear film stability, reduced corneal aberration parameters, and enhanced vision-related quality of life in children with OK-associated DED. Trial registration number and date of registration 08/08/2024 (NCT06537349).