QUALITY OF LIFE WITH THREE SCHEDULES IN DRY EYE DISEASE PATIENTS: A COMPARATIVE STUDY

Misra S.*, Kaushal J. and Khurana A. K.

ABSTRACT

Introduction: Dry eye disease is defined as a multifactorial disease of tears and ocular surface that results in symp-toms of discomfort, visual disturbance and tear film instability. This study was done to observe improvement in quality of life of loteprednol versus cyclosporine A as an add on therapy to carboxymethyl cellulose (CMC) versus CMC alone in dry eye disease patients. Materials & Methods: A prospective, randomized, comparative clinical study was conducted on 60 patients and they were randomly divided in three groups of 20 each. Group A: CMC 1% 6 times a day as monotherapy, Group B: CMC 1% 6 times a day and loteprednol 0.5% 4 times a day and Group C: CMC 1% 6 times a day and cyclosporine A 0.5% 4 times a day for a period of 8 weeks. Quality of life assess-ment was done by ocular surface disease index (O.S.D.I) and Likert scale. Results: On intragroup analysis, O.S.D.I score in group A, B and C there was decrease in score by 7.94, 11.78 and 15.4 respectively at the end of 2 weeks compared to their baseline values (p<0.05). At the end of 8 weeks in group A, B and C there was still reduction of score by 33.5, 39.04 and 38.64 respectively compared to their baseline values (p< 0.05). On intergroup analysis, at the end of 2 weeks, statistically significant better response was seen with group B and C as compared to group A which continued till the end of 8 weeks. When group B and C were compared with each other, better response was seen with group B which continued till the end of 8 weeks. In likert scale, patients were asked to evaluate the relief according to five level Likert item e.g Strongly agree, Agree, Neither agree nor disagree (Neutral), Disagree, Strongly disagree. More patients agreed for relief of symptoms with CMC plus lotedrednol as compared to CMC plus cyclosporine A and CMC as mono therapy but the difference was not statistically significant. Discussion: Loteprednol plus CMC showed more improvement in quality of life than other two groups in both parameters. None of the studies could be found where similar schedules were compared to observe these effects.

Keywords: Carboxymethyl cellulose, loteprednol, ocular surface disease index, cyclosporine A.