Hypochlorous Acid Hygiene Solution Versus Hyaluronic Acid Wipes For Blepharitis Treatment: A Prospective Randomized Study

To investigate clinical outcomes and antimicrobial activity of an hypochlorous acid hygiene solution compared with hyaluronic acid wipes for blepharitis treatment in patients with mild to moderate dry eye disease.

Eye clinic, Careggi Hospital, University of Florence, ItalyEye clinic, Careggi Hospital, University of Florence, Italy

Prospective randomized comparative study of 48  eyes of 48 patients affected by  blepharitis. Patients were divided in two groups: group 1 was treated with an hypochlorous acid hygiene solution and group 2 was treated with hyaluronic acid wipes for a total treatment period of 4 weeks. The following clinical outcomes were assessed before (T0) and after the treatment period (T1): Non Invasive Keratograph Break up time, tear film break up time, tear meniscus height, meibography, corneal staining score, shirmer test I, conjunctival redness and ocular surface disease index (OSDI). Moreover, microbiological analysis of upper and lower eyelids was performed at T0 before and 10 minutes after treatment.

 

Baseline assessments did not differ between the two groups. After the 4 weeks treatment period NIK-BUT and TF-BUT significantly decreased in group 1, while they did not show a statistically significant reduction in group 2. OSDI and tear meniscus height showed a significant reduction in both groups. Shirmer test, meibography, corneal staining score and conjunctival redness score did not show a statistically significant reduction after treatment period in both groups. Bacterial load showed a significant reduction in both groups, more pronounced in group 1 compared with group 2 (average bacterial load reduction of 80% in group 1 and 66% in group 2).

Hypochlorous acid hygiene solution can be securely employed in blepharitis treatment considering the satisfying clinical outcomes and antimicrobial activity compared with hyaluronic acid wipes. Moreover, the treatment with Hypochlorous acid solution was found to be well tolerated by the patients since no severe adverse effect were recorded during the study.