Efficacy of 0.1% crosslinked hyaluronic acid, coenzyme Q10 and vitamin E in the management of dry eye disease in menopause patients receiving antidepressants

Purpose: The purpose of this study is to test non-inferiority of a lower dose of crosslinked hyaluronic acid (CLHA) to a higher dose of carmellose eye drop in menopause patients receiving antidepressant treatments. Methods: This prospective, double-blind, single-center study enrolled sixty female patients. Mean age was 63.25 +/- 9.13 years. We examined patients with Schirmer I, breakup time (TBUT) and the ocular surface disease index (OSDI) at the first visit. Tear A eyedrops were formulated with crosslinked hyaluronic acid, coenzyme Q10 and vitamin E. Control tear B was formulated with carmellose sodium. Posology was two and five times, respectively. Results: After 2 months of treatment, the tear A obtained 14.12 +/- 7.47 score points for OSDI (t = 11.74, p < 0.01), and tear B obtained 19.46 +/- 10.03 score points (t = 7.59, p < 0.01). The tear A obtained 13.77 +/- 7.78 score points for Schirmer test (t = 0.88, p > 0.05), and tear B obtained 14.20 +/- 8.62 score points (t = 2.92, p < 0.01). The tear A obtained 8.30 +/- 2.08 s for TBUT (t = 15.50, p < 0.01), and tear B obtained 7.23 +/- 2.40 s (t = 8.79, p < 0.01). Conclusion: Lower total daily dose of crosslinked hyaluronic acid eyedrops obtained similar efficacy results in terms of tear stability and subjective dry eye sensation than higher carmellose total daily dose. A lower total daily dose of crosslinked eyedrops was sufficient to achieve better dry eye disease management compared to carmellose.