Systane lubricant eye drops in the management of ocular dryness

Umberto Benelli, Umberto Benelli

Abstract

The understanding of dry eye disease has advanced recently through increasing recognition that the etiology of the condition involves both tear evaporation and insufficient tear production, and that tear film instability and inflammation play roles in the various stages of the disease. Of significance, it has been recognized that lipid layer thickness correlates with tear film stability. The management of dry eye involves various strategies and therapeutic approaches that address one or more etiopathological components of the disease. The purpose of this review is to outline the characteristics and clinical utility of the Systane(®) ocular lubricants that contain hydroxypropyl-guar and one or both of the demulcents, ie, polyethylene glycol 400 and propylene glycol. Clinically, these products are safe and are indicated for the temporary relief of burning and irritation due to dryness of the eye. In particular, this review describes the formulations, mechanisms of action, and clinical utility of the newest additions to this topical ocular lubricant family, Systane Ultra(®) and Systane Balance(®). Both of these ocular products are formulated with an intelligent delivery system and both provide symptomatic relief to patients with dry eye. However, Systane Balance is a novel formulation that contains both polymer and lipid components designed to protect the ocular surface and replenish tear film lipids simultaneously, a factor that is of particular relevance to patients who have dry eye associated with meibomian gland dysfunction.

Keywords: Systane Balance; Systane Ultra; dimyristoylphosphatidylglycerol; dry eye; hydroxypropyl-guar; meibomian gland dysfunction.

References

    1. International Dry Eye WorkShop The definition and classification of dry eye disease: Report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007) Ocul Surf. 2007;5(2):75–92.
    1. Perry HD. Dry eye disease: Pathophysiology, classification, and diagnosis. Am J Manag Care. 2008;14(3 Suppl):S79–S87.
    1. Lemp MA. Management of dry eye disease. Am J Manag Care. 2008;14(3 Suppl):S88–S101.
    1. Gayton JL. Etiology, prevalence, and treatment of dry eye disease. Clin Ophthalmol. 2009;3:405–412.
    1. Foulks GN. Treatment of dry eye disease by the non-ophthalmologist. Rheum Dis Clin North Am. 2008;34(4):987–1000.
    1. International Dry Eye WorkShop The epidemiology of dry eye disease: Report of the Epidemiology Subcommittee of the International Dry Eye WorkShop (2007) Ocul Surf. 2007;5(2):93–107.
    1. Gifford P, Evans BJ, Morris J. A clinical evaluation of Systane. Cont Lens Anterior Eye. 2006;29(1):31–40.
    1. Rosenfeld SI. Evaluation and management of post-LASIK dry eye syndrome. Int Ophthalmol Clin. 2010;50(3):191–199.
    1. Friedman NJ. Impact of dry eye disease and treatment on quality of life. Curr Opin Ophthalmol. 2010;21(4):310–316.
    1. Pflugfelder SC. Prevalence, burden, and pharmacoeconomics of dry eye disease. Am J Manag Care. 2008;14(3 Suppl):S102–S106.
    1. Foulks GN. The correlation between the tear film lipid layer and dry eye disease. Surv Ophthalmol. 2007;52(4):369–374.
    1. Foulks GN, Borchman D. Meibomian gland dysfunction: The past, present, and future. Eye Contact Lens. 2010;36(5):249–253.
    1. Bron AJ, Tiffany JM. The contribution of meibomian disease to dry eye. Ocul Surf. 2004;2(2):149–165.
    1. Bron AJ, Tiffany JM, Gouveia SM, Yokoi N, Voon LW. Functional aspects of the tear film lipid layer. Exp Eye Res. 2004;78(3):347–360.
    1. Craig JP, Tomlinson A. Importance of the lipid layer in human tear film stability and evaporation. Optom Vis Sci. 1997;74(1):8–13.
    1. Blackie CA, Solomon JD, Scaffidi RC, Greiner JV, Lemp MA, Korb DR. The relationship between dry eye symptoms and lipid layer thickness. Cornea. 2009;28(7):789–794.
    1. Lemp MA, Foulks GN, Devgan U, Trattler WB, Nichols KK. The therapeutic role of lipids: Managing ocular surface disease. Refractive Eyecare for Ophthalmologists. 2005;9(Suppl):3–15.
    1. Dry Eye WorkShop Management and therapy of dry eye disease: Report of the Management and Therapy Subcommittee of the International Dry Eye WorkShop (2007) Ocul Surf. 2007;5(2):163–178.
    1. Christensen MT, Cohen S, Rinehart J, et al. Clinical evaluation of an HP-guar gellable lubricant eye drop for the relief of dryness of the eye. Curr Eye Res. 2004;28(1):55–62.
    1. Springs CL. Novel hydroxypropyl-guar gellable lubricant eye drops for treatment of dry eye. Adv Ther. 2010;27(10):681–690.
    1. Foulks GN. Clinical evaluation of the efficacy of PEG/PG lubricant eye drops with gelling agent (HP-Guar) for the relief of the signs and symptoms of dry eye disease: A review. Drugs Today (Barc) 2007;43(12):887–896.
    1. Springs C. Novel ocular lubricant containing an intelligent delivery system: Details of its mechanism of action. Dev Ophthalmol. 2010;45:139–147.
    1. Christensen MT. Corneal staining reductions observed after treatment with Systane® Lubricant Eye Drops. Adv Ther. 2008;25(11):1191–1199.
    1. SYSTANE® lubricant eye drops. Available at: . Accessed March 14, 2011.
    1. Ubels JL, Clousing DP, Van Haitsma TA, et al. Pre-clinical investigation of the efficacy of an artificial tear solution containing hydroxypropyl-guar as a gelling agent. Curr Eye Res. 2004;28(6):437–444.
    1. Tripathi BJ, Tripathi RC, Kolli SP. Cytotoxicity of ophthalmic preservatives on human corneal epithelium. Lens Eye Toxic Res. 1992;9(3–4):361–375.
    1. Meyer AE, Baier RE, Chen H, Chowhan M. Differential tissue-on-tissue lubrication by ophthalmic formulations. J Biomed Mater Res B Appl Biomater. 2007;82(1):74–88.
    1. Hartstein I, Khwarg S, Przydryga J. An open-label evaluation of HP-guar gellable lubricant eye drops for the improvement of dry eye signs and symptoms in a moderate dry eye adult population. Curr Med Res Opin. 2005;21(2):255–260.
    1. Rolando M, Autori S, Badino F, Barabino S. Protecting the ocular surface and improving the quality of life of dry eye patients: A study of the efficacy of an HP-guar containing ocular lubricant in a population of dry eye patients. J Ocul Pharmacol Ther. 2009;25(3):271–278.
    1. Ousler GW, Michaelson C, Christensen MT. An evaluation of tear film breakup time extension and ocular protection index scores among three marketed lubricant eye drops. Cornea. 2007;26(8):949–952.
    1. Benelli U, Nardi M, Posarelli C, Albert TG. Tear osmolarity measurement using the TearLab Osmolarity System in the assessment of dry eye treatment effectiveness. Cont Lens Anterior Eye. 2010;33(2):61–67.
    1. Paugh JR, Nguyen AL, Huang P, Hwang JS. Retention and retention of effect of topical formulations in dry eye subjects. Optom Vis Sci. 2008;85(9):873–879.
    1. Sanchez MA, Arriola-Villalobos P, Torralbo-Jimenez P, et al. The effect of preservative-free HP-Guar on dry eye after phacoemulsification: A flow cytometric study. Eye (Lond) 2010;24(8):1331–1337.
    1. Versura P, Profazio V, Campos EC. One month use of Systane improves ocular surface parameters in subjects with moderate symptoms of ocular dryness. Clin Ophthalmol. 2008;2(3):629–635.
    1. Durrie D, Stahl J. A randomized clinical evaluation of the safety of Systane lubricant eye drops for the relief of dry eye symptoms following LASIK refractive surgery. Clin Ophthalmol. 2008;2(4):973–979.
    1. Ousler GW, Hagberg KW, Schindelar M, Welch D, Abelson MB. The Ocular Protection Index. Cornea. 2008;27(5):509–513.
    1. Sall KN, Cohen SM, Christensen MT, Stein JM. An evaluation of the efficacy of a cyclosporine-based dry eye therapy when used with marketed artificial tears as supportive therapy in dry eye. Eye Contact Lens. 2006;32(1):21–26.
    1. Kading D. A two-week clinical evaluation of the safety of Systane Ultra in contact lens-wearing patients. Clin Ophthalmol. 2010;4:27–32.
    1. Davitt WF, Bloomenstein M, Christensen M, Martin AE. Efficacy in patients with dry eye after treatment with a new lubricant eye drop formulation. J Ocul Pharmacol Ther. 2010;26(4):347–353.
    1. Systane® Ultra lubricant eye drops. Available at: . Accessed March 14, 2011.
    1. Systane® Balance lubricant eye drops. Available at: . Accessed March 14, 2011.
    1. Ketelson HA, Davis J, Meadows D. Characterization of an anionic lipid stabilized ocular emulsion containing HP-guar. Invest Ophthalmol Vis Sci. 2010;43 Abstract D892.
    1. Korb DR, Blackie CA, Meadows D, Christensen MT, Tudor MR. Evaluation of extended tear stability by two emulsion based artificial tears. Proceedings of the 6th International Conference on the Tear Film and Ocular Surface: Basic Science and Clinical Relevance Tear Film and Ocular Surface Society meeting; Florence, Italy. September 22–25, 2010.
    1. Foulks G, Sindt C, Griffin J. Efficacy evaluation of a novel emulsion based, anionic phospholipid containing artificial tear in meibomian gland dysfunction (MGD) subjects. Proceedings of the 6th International Conference on the Tear Film and Ocular Surface: Basic Science and Clinical Relevance Tear Film and Ocular Surface Society meeting; Florence, Italy. September 22–25, 2010.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir