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. 2024 Jun 18;17(6):1110-1119.
doi: 10.18240/ijo.2024.06.17. eCollection 2024.

Different concentrations of hyaluronic acid eye drops for dry eye syndrome: a systematic review and Meta-analysis

Xiao-Wei Ouyang  1 , Sheng Fang  2 , Yun-Min Yi  3 , Shi-Peng Zou  4 , Qi-Yu Hu  1 , Zi-Xuan Huang  1 , Qing-Xia Li  1 , Jin-Yan Luo  1
Affiliations

Different concentrations of hyaluronic acid eye drops for dry eye syndrome: a systematic review and Meta-analysis

Xiao-Wei Ouyang et al. Int J Ophthalmol. .

Abstract

Aim: To compare high or low concentration of hyaluronic acid eye drops (HY) for dry eye syndromes (DES).

Methods: Randomized controlled trials (RCTs) comparing various concentrations of HY were searched in PubMed, Embase, Web of Science, Cochrane, SinoMed, CNKI, Wanfang Database, CQVIP, and Chinese journals databases between inception and July 2023. Pooled standardized mean differences (SMD) or weighted mean difference (WMD) with 95% confidence intervals (CI) from RCTs evaluating Schirmer's I test (SIT), corneal fluorescein staining score (CFS), tear breakup time (TBUT), DES score (DESS), and Ocular Surface Disease Index (OSDI) were calculated. Sensitivity analysis, Egger's test and Meta-regression analysis were performed for all indicators.

Results: We conducted a Meta-analysis of 10 RCTs that met the inclusion criteria, involving 1796 cases. High-concentrations group significantly improved the outcome of CFS according to random effects modelling (SMD, -3.37; 95%CI, -5.25 to -1.48; P=0.0005). The rest of the results were not statistically significant, including indicators such as SIT, TBUT, DESS and OSDI.

Conclusion: For dry eyes with positive corneal staining, a high concentration of HY is recommended, whereas in other cases, a high concentration of HY does not offer a more pronounced advantage over a low concentration of HY in the treatment of dry eyes.

Keywords: Meta-analysis; concentration; dry eye; hyaluronic acid.

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Conflict of interest statement

Conflicts of Interest: Ouyang XW, None; Fang S, None; Yi YM, None; Zou SP, None; Hu QY, None; Huang ZX, None; Li QX, None; Luo JY, None.

Figures

Figure 1
Figure 1. Selection process for the study.
Figure 2
Figure 2. The results of the risk of bias assessment.
Figure 3
Figure 3. Forest plot results for each baseline data.
Figure 4
Figure 4. Forest plot and Egger's test of Schirmer's I test.
Figure 5
Figure 5. Forest plot and Egger's test, Trim and Fill analysis of tear breakup time.
Figure 6
Figure 6. Forest plot and Egger's test of dry eye symptom score.
Figure 7
Figure 7. Forest plot and Egger's test, Trim and Fill analysis of corneal fluorescein staining score.
Figure 8
Figure 8. Forest plot and Egger's test of ocular surface disease index.
Figure 9
Figure 9. Sensitivity analysis of each result
SIT: Schirmer's I test; TBUT: Tear break-up time; DESS: Dry eye symptom score; CFS: Corneal fluorescein staining score; OSDI: Ocular Surface Disease Index.
Figure 10
Figure 10. Meta-regression of each result.
See this image and copyright information in PMC

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