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JOURNAL WATCH
date_range 02 DEC 2021
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Carboxymethylcellulose vs. Polyethylene Glycol as Tear Substitutes for Dry Eye Treatment
Ophthalmology
Pediatric Ophthalmology
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Synopsis
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Dry eye disease (DED) can be caused either by a lack of tear production or excessive evaporation. Multifactorial
characters such as tear film, ocular surface, or neurosensory disorders result in changes in tear film osmolarity and ocular
surface inflammation. The symptoms can be related to ocular pain, such as burning, irritation, grittiness, or vision-related.
The severity of the condition determines the treatment, with mild cases requiring only tear replacements and severe
cases requiring additional medical or surgical intervention. Artificial tears replace the aqueous layer that has become
depleted and dissolves inflammatory cytokines.
This “Journal Watch” discusses a prospective randomized control study from the International Journal of Medical and
Health Research, entitled ‘Comparison of carboxymethylcellulose versus polyethylene glycol as tear substitutes for the
treatment of dry eye,’ 2019.
What was the need of the study?
The most widely prescribed treatment for dry eyes is artificial tear replacement. It reduces ocular surface stress and
improves tear film stability, contrast sensitivity, optical quality, and quality of life.
Carboxymethylcellulose (CMC) and polyethylene glycol (PEG) are the two most commonly used tear replacements.
However, the clinical efficacy of these two substitutes has remained unexplored.
Study design
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What did the treatment include?
Patients were randomly sampled into two groups. Patients in group I received CMC 1% QID, while group II received PEGcontaining drops QID (PEG-400 0.4%, propylene glycol 0.3 %). From each patient, one eye was selected as the study eye. If
both the eyes met the inclusion criteria, the worse evaluable eye was selected. If both the eyes shared the same total ocular
symptom score (TOSS) scores, the right eye was selected.
On-treatment follow-up visits were conducted after 1 week and 6 weeks.
What were the important findings?
Significance of the study
Both CMC 1% and PEG-containing eye drop effectively treated dry eye, with improvement in clinical signs and symptoms.
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Patient-response to PEG-containing eye drops was faster, with a significant improvement in OSDI score from baseline to
week 1 follow-up. In addition, improvement in OSDI score and corneal staining score was significantly better in the PEG
group at 6 weeks, as compared to the CMC group.
Improvement in other metrics such as TBUT, conjunctival staining score, and ST did not exhibit the statistical difference
between the two groups. This suggests that eye drops containing PEG are better for patient satisfaction and improve ocular
surface staining scores.
Conclusion
PEG and CMC both treatments decreased ocular surface staining, indicative of improved ocular surface health. Moreover,
both alleviated objective signs and symptoms of DED. However, the study results suggested that PEG-containing eye drops
provide quicker and better subjective improvement and corneal staining than CMC 1% eye drops.
Reference
Shilpy N, Patel DB. Comparison of carboxymethylcellulose versus polyethylene glycol as tear substitutes for the treatment
of dry eye. International Journal of Medical and Health Research. 2019 Jan;5(1):196-198.
IN-DEOH-2100056
Disclaimer: “For the use only of registered medical practitioners or a hospital or a laboratory”
Disclaimer:
“This educational information has been issued as part of awareness initiative by Alcon. In spite of best efforts, this information may become
outdated over time. Alcon Laboratories (India) Pvt. Ltd. accepts no liability for the completeness for use of the information contained
herewith or its update. Information, statements and photographs / recordings used here are with the permission of all and must not be
replicated.”
What is your opinion on using PEG over CMC to treat dry eyes? (Please comment below).
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16 Comments - 12 Like
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Highly effective compared to CMC
Better improvement in dry eyes
Better corneal staining scores
Dr. Ashok Agarwal MBBS
Better improvement in dry eyes
Reply
Response Squad
Dear doctor, thank you for sharing your thoughts with us. Stay tuned for more on Dry Eye
Disease at https://www.docplexus.com/#/app/infocenters/3EA9J
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Dr. Shobhit Chawla Eye care professional
Useful study, justices basis of prescription
Reply
Response Squad
Dear doctor, thank you for sharing your thoughts with us. Stay tuned for more on Dry Eye
Disease at https://www.docplexus.com/#/app/infocenters/3EA9J
Dr. Parmeshwaridayal Gupt... Ophthalmology
Useful study
Reply
Response Squad
Dear doctor, thank you for sharing your thoughts with us. Stay tuned for more on Dry Eye
Disease at https://www.docplexus.com/#/app/infocenters/3EA9J
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Dr. Kapil Sharma Works at Vision Care Eye Clinic, No...
Highly effective compared to CMC
Reply
Response Squad
Dear doctor, thank you for sharing your thoughts with us. Stay tuned for more on Dry Eye
Disease at https://www.docplexus.com/#/app/infocenters/3EA9J
Dr. Suhail Mohammed Radiology
Good
Reply
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Dear doctor, thank you for sharing your thoughts with us. Stay tuned for more on Dry Eye
Disease at https://www.docplexus.com/#/app/infocenters/3EA9J
Dr. Suhail Mohammed Radiology
Better improvement in dry eyes Knowledge to share
Reply
Response Squad
Dear doctor, thank you for sharing your thoughts with us. Stay tuned for more on Dry Eye
Disease at https://www.docplexus.com/#/app/infocenters/3EA9J
Dr. Chetankumar Prajapat... MD Medicine
Highly effective compared to CMC
Reply
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Response Squad
Dear doctor, thank you for sharing your thoughts with us. Stay tuned for more on Dry Eye
Disease at https://www.docplexus.com/#/app/infocenters/3EA9J
Dr. Irwan Tjandra Ophthalmology
Highly effective compared to CMC
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