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Comparison of Treatment Modalities for Dry Eye in Primary Sjögren's Syndrome

 Hyunmin Ahn  ;  Yong Woo Ji  ;  Ikhyun Jun  ;  Tae-Im Kim  ;  Hyung Keun Lee  ;  Kyoung Yul Seo 
 JOURNAL OF CLINICAL MEDICINE, Vol.11(2) : 463, 2022-01 
Journal Title
Issue Date
Sjögren’s syndrome ; dry eye ; ocular surface inflammation ; punctal plug
Purpose: To evaluate the effectiveness of different treatment modalities for dry eye in primary Sjögren's syndrome with their potential overlapping influences.

Methods: This study included 199 patients with newly diagnosed primary Sjögren's syndrome from 2005 to 2020. Various treatment modalities for primary Sjögren's syndrome were compared. Improvement of corneal staining based on Sjögren's International Collaborative Clinical Alliance (SICCA) scores was the primary outcome.

Results: The average follow-up period was 5.4 ± 3.1 (range, 2.0-14.1) years. Analysis of the individual treatments showed that punctal plug insertions in the lower and upper eyelids were strongly associated with improvement of SICCA scores (β = 2.70 and 1.80, p < 0.001 and <0.001, respectively). With ocular surface inflammation, corneal staining scores improved significantly with steroid eye drops. Prednisolone (1%) had the strongest association with improvement of corneal staining scores (β = 1.48, p < 0.001); this was based on the frequency of administration. Without ocular surface inflammation, diquafosol (3%), carbomer gel, and lanolin ointment were effective (β = 1.37, 1.06, and 1.17; p = 0.003, 0.003, and <0.001, respectively).

Conclusions: Punctal plug insertion, primarily targeting aqueous deficiency, is the mainstay of the treatment for dry eye in primary Sjögren's syndrome even in the presence of ocular surface inflammation. Furthermore, the effectiveness of treatment modalities for dry eye in primary Sjögren's syndrome was dependent on the presence of ocular surface inflammation.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae-Im(김태임) ORCID logo https://orcid.org/0000-0001-6414-3842
Seo, Kyoung Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
Ahn, Hyunmin(안현민)
Lee, Hyung Keun(이형근) ORCID logo https://orcid.org/0000-0002-1123-2136
Jun, Ik Hyun(전익현) ORCID logo https://orcid.org/0000-0002-2160-1679
Ji, Yong Woo(지용우) ORCID logo https://orcid.org/0000-0002-7211-6278
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