Comparison of the Clinical Efficacy of Four Different Liposomal Sprays for the Treatment of Dry Eye

Purpose: To compare the clinical efficacy of four different liposomal sprays for dry eye treatment. Methods: Prospective randomized consecutive intraindividual comparison enrolling 166 patients (age, 18 - 93 years). Patients were randomly assigned to one of 4 groups, receiving one spray in their right eye and another one in their left eye: Ocuvers Hyaluron (OH) (87 eyes) and Ocuvers Lipostamin (OL) (80 eyes) (Innomedis AG), and Tears Again (TA) (80 eyes) and Tears Again Sensitive (TAS) (85 eyes) (Optima Pharmaceutical). Symptomatology was evaluated with the OSDI (Ocular Surface Disease Index) questionnaire. Subjective comfort, tear break up time (TBUT), redness, tear meniscus, application comfort and smell were evaluated during a 30-minute follow-up. Results: Smell for TA and TAS was significantly fattier compared to OH and OL (p < 0.001). After application of TA, patients reported significantly more burning sensations compared to the rest of the sprays (p < 0.001). At 10 minutes, subjective comfort (p ≤ 0.027) and TBUT (p ≤ 0.004) were significantly better with OH and OL compared to TA and TAS. At 30 minutes, the same trends were observed, with also significantly less ocular redness with OL compared to the rest (p = 0.043). Significant correlations were found between baseline OSDI and changes in ocular redness at 10 (r = -0.287, p = 0.011) and 30 minutes (r = -0.237, p = 0.037) after the application of OL. Conclusions: The four evaluated liposome sprays may be useful for dry eye treatment, with higher subjective comfort and less dry eye signs using the Ocuvers sprays. The use of OL may be a better treatment option for severe dry eye.