Efficacy Of 0.15% Hyaluronic Acid Vs. 0.5% Carboxymethylcellulose Sodium In Combination With Rebamipide 2% For Post-Cataract Surgery Dry Eye Management

This study aims to compare the therapeutic efficacy of 0.5% carboxymethylcellulose sodium (CMC) and 0.15% hyaluronic acid (HA), each combined with 2% topical rebamipide, in managing dry eye following cataract surgery.  Both 0.5% carboxymethylcellulose sodium and 0.15% hyaluronic acid are commonly prescribed for dry eye management and are considered to have comparable efficacy. However, their effectiveness when combined with 2% rebamipide remains uncertain and requires further investigation.

This single-center study was conducted at Saevit Eye Hospital in Goyang, Korea. It included newly diagnosed dry eye patients who had undergone cataract surgery, specifically phacoemulsification with intraocular lens implantation.

Patients who had undergone cataract surgery were evaluated and diagnosed for dry eye one week postoperatively. They were then randomly assigned to one of two groups: the CMC group, which received 2% rebamipide with 0.5% CMC eye drops, or the HA group, which received 2% rebamipide with 0.15% HA eye drops. Dry eye-related tests, including Schirmer's test, tear break-up time (TBUT), ocular surface staining scores, tear film osmolarity, tear lipid layer thickness, and the Ocular Surface Disease Index (OSDI), were conducted in both groups at one and two months postoperatively.

Both groups showed significant improvement in TBUT and ocular surface staining scores at one and two months postoperatively compared to baseline (CMC group: 1 month, p < 0.001, p = 0.012; 2 months, p < 0.001, p < 0.001; HA group: 1 month, p < 0.001, p < 0.001; 2 months, p < 0.001, p < 0.001). Schirmer’s test results significantly improved in the CMC group throughout the study (1 month, p < 0.001; 2 months, p < 0.001) but remained unchanged in the HA group (1 month, p = 0.108; 2 months, p = 0.709). After two months of treatment, the two groups were comparable in TBUT, ocular surface staining scores, and OSDI (p = 0.399, p = 0.056, p = 0.106).

The combination of 0.5% CMC or 0.15% HA with topical 2% rebamipide was effective in improving dry eye-related parameters in post-cataract surgery dry eye. Since both artificial tears demonstrated similar efficacy, the choice between them may depend on the physician’s preference and individual patient needs.