Ophthalmology in China ›› 2023, Vol. 32 ›› Issue (2): 108-119.doi: 10.13281/j.cnki.issn.1004-4469.2023.02.006

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Meta-analysis of the latest randomized controlled trials of clinical treatments for dry eye disease

Ning Ken1, Wang Xinming2, Li Ying1, Yu Yang3, Zhu Zhou1, Qu Xingfang4   

  1. 1Department of Ophthalmology, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing 100730, China;  2Basic Medical Science Institute, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China; 3Department of Biochemistry & Molecular Biology, Pennsylvania State University, State College, PA 16801 , USA; 4School of International Chinese Language Education, Beijing Normal University, Beijing 100875, China
  • Received:2022-12-02 Online:2023-03-25 Published:2023-03-25
  • Contact: Li Ying, Email: liyingpumch@126.com　

Abstract: Objective To summarize and analyze the curative effect, advantages and disadvantages of cyclosporine, glucocorticoids, non-steroidal eye drops and combination therapy in dry eye disease. Design Meta-analysis. Participants Random controlled trial (RCT) researches that were conducted for dry eye treatment. Methods The RCT researches on cyclosporine, glucocorticoids and non-steroidal eye drops in the treatment of dry eye up to August 7, 2022 were searched. The included literature data were analyzed using the R Meta (5.2.0) software package. Main Outcome Measures Schirmer test (SIT), tear film breakup time (TBUT), corneal fluorescein staining (FL), symptom score, effective rate and incidence of adverse reactions. Results A total of 5850 cases (7945 eyes) from 57 randomized controlled trials were included. There were 3008 cases (4056 eyes) in the test group and 2842 cases (3889 eyes) in the control group. The results showed that there was no significant difference in the adverse event rate of glucocorticoids and non-steroidal drugs compared with the control group, but the adverse event rate of cyclosporine was higher than that of the control group, and the dry eye scores of the three drugs were significantly better than those of the control group. All three classes of drugs significantly improved the outcomes of TBUT and FL. SIT (without anesthesia) was significantly higher in the cyclosporine eye drop test group than in the control group. There were no significant differences between the combined drug group and the single drug group in SIT (no anesthesia), TBUT, and FL. Conclusion Based on the data of this Meta-analysis, cyclosporine, glucocorticoids, and non-steroidal eye drops can all effectively improve and treat dry eye. Cyclosporin and glucocorticoid eye drops have advantages and disadvantages in improving various indicators, and both are better than non-steroidal eye drops. The combination of glucocorticoid and cyclosporine has no significant advantage over glucocorticoid or cyclosporine alone, but the combination did not lead to a significant increase in the rate of adverse reactions. (Ophthalmol CHN, 2023, 32: 108-119)

Key words: dry eye/treatment, Meta-analysis