Conjunctival and Tear film changes in patients of Dry eye using PVA +Povidone with and without Preservatives-A Clinico Cytological Study

Muralidharan Ponnurangam

Purpose: To study the Conjunctival and Tear film changes in patients of Dry eye using PVA +Povidone with and without Preservatives-A Clinico Cytological Study.

Methods: A prospective, randomized, case control study of 60 newly diagnosed cases of dry eye (Schirmer's basic secretion test <10mm) were randomly and equally divided into 3 groups, A, B & C which were prescribed Polyvinyl alcohol (1.4%) and Povidone (0.6%) with Benzalkonium chloride (0.01%), Chlorbutanol (0.5%) and Preservative free UNIMS respectively.20 cases (Group D) age and sex matched were taken as controls for baseline evaluation. Patients were studied at initial visit and followed up at every 2 weeks for a period of 12 weeks and assessed for clinical symptoms, conjunctival signs, tear film BUT and Schirmer's at each visit. Conjunctival impression cytology (CIC) was done at 0, 4, 8 and 12 wks, after starting treatment for Dry eye in the first visit. Statistical analysis was done using SPSS software.

Results: All the tear substitutes in the study brought about a significant improvement in subjective symptoms by 8 weeks (p<0.04).Tear film studies also showed significant (p<0.001) improvement in all the study groups by 12 weeks. A significant improvement in Schirmer's value (p<0.012) was seen by 8 weeks. However a significant improvement (p<0.014) in GCD was seen only at 12 weeks. No significant reversal of squamous metaplasia was seen.

Conclusion: PVA+Povidone with and without preservatives were found to be equally effective.