Table 1.
Summary of published papers and clinical trials comparing artificial tears
| Comparison data between various brands of artificial tears
| |||
|---|---|---|---|
| Drops examined | ST/SS | Trial results | P-value |
| Systane® versus Refresh Tears®,37 | Double blinded RCT/87 | After 14 days of daily therapy, Systane-treated patients exhibited decreased conjunctival staining and diminished temporal corneal staining compared to patients treated with Refresh Tears | Conjunctival stain: 0.025 Temporal stain: 0.024 |
| Systane® versus Refresh Tears® versus\Refresh Endura®,38 | Double blinded, three-way cross-over, RCT/50 | At 5, 10, 15, 20, and 60 minutes after application, Systane significantly prolonged tear break-up time compared to either Refresh therapies | 5, 10, 15, 20, 60 minutes <0.05 |
| Systane® versus Refresh Liquigel®,30 | Open-label, RCT/60 | Clinical trial revealed patient preference for Refresh Liquigel (36%) compared with Systane (24%). Mean corneal inferior staining was only significantly reduced in patients treated with Refresh Liquigel | Patient preference P not provided Corneal staining <0.001 |
| Blink8 Intensive versus Systane® versus\Refresh Celluvisc®,44 | Investigator masked RCT/60 | At treatment day 30, the mean decrease in osmolarity 5 minutes postapplication was significantly greater with Blink Tears compared to Systane and Refresh | Osmolarity decrease <0.001 |
| Blink® Tears versus Systane® Ultra45 | Investigator masked, cross-over, RCT/40 | After 1 month of therapy, TBUT was significantly increased by 2.4 seconds with Blink Tears while Systane Ultra showed no statistically significant increase in tear film | TBUT increase 0.003 |
| Blink® Tears versus Refresh Optive®,31 | Investigator masked, cross-over, RCT/50 | After 16 days of therapy with either Blink Tears or Refresh Optive, patients reported similar improvement on the Dry Eye Disease Comfort Assessment questionnaire | P not provided |
| Refresh Liquigel® versus Refresh Tears®,41 | Double blinded, cross-over, RCT/39 | Refresh Liquigel (1.0% CMC) increased TBUT for a longer time when compared with Refresh Tears (0.5% CMC) | <0.05 |
| Refresh Liquigel® versus Refresh Tears®,24 | Subject masked, parallel-group, RCT/99 | Corneal staining reduced greater from baseline with Refresh Liquigel than Refresh Tears, but more adverse events occurred with the Liquigel | Corneal staining 0.011 Adverse events 0.006 |
| Refresh Plus® versus Refresh Liquigel® versus Refresh Celluvisc®,42 | Subject masked, controlled trial/20 | Both Refresh Liquigel and Refresh Celluvisc significantly decreased contrast sensitivity | Decreased contrast sensitivity <0.001 |
| Refresh Optive® versus Systane® versus Hylo-Comod®,39 | Open-label, observational study/5277 | Questionnaire revealed 68.9% of Hylo-Comod users and 78.5% of Systane users had improvement of symptoms by switching to Refresh Optive. TBUT also improved with Refresh | Symptom improvement P not provided TBUT improvement <0.001 |
| Refresh Tears® versus Refresh Ultra® versus Refresh Optive®,43 | Double-blinded, cross-over, RCT/38 | Refresh Optive and Refresh Ultra improved patient symptoms greater than Refresh Tears | Optive 0.013 Ultra 0.011 |
| Systane® Ultra versus Refresh Optive®,36 | Double-blinded, cross-over RCT/48 | At 90 minutes after application, Systane Ultra users maintained BCVA for 9.17±0.0365 seconds compared to 6.84±0.0365 seconds of maintained BCVA in Refresh Optive users | P not provided |
| Systane® Ultra versus Refresh Optive®,40 | Double-blinded, parallel, RCT/109 | On a unit scale of 0–15, with 0 being no staining and 15 the most staining, corneal staining after 42 days of treatment with Systane Ultra showed 2.9±1.8 units of corneal staining compared to 4.2±2.8 units of corneal staining in those treated with Refresh Optive | P not provided |
| Systane® Ultra versus Refresh Optive® versus GenTeal® versus Blink® Tears46 | Double-blinded, cross-over, RCT/20 | Posttherapeutic subjective comfort results revealed Systane Ultra outperformed Refresh Optive, GenTeal, and Blink Tears | P not provided |
| Soothe® versus Refresh Optive®,47 | Double-blinded, cross-over, RCT/41 | The mean lipid layer thickness increase was significantly greater in eyes treated with Soothe (60.0 nm) compared to eyes treated with Refresh (23.6 nm) | Refresh <0.0001 Soothe <0.0001 Comparison <0.0001 |
| Soothe® versus Systane®,48 | Double-blinded, cross-over, RCT/40 | The lipid layer thickness increase was significantly greater in eyes treated with Soothe compared to eyes treated with Systane | Systane <0.0001 Soothe <0.0001 Comparison <0.0001 |
| GenTeal® Tears versus Naturale-Free®,50 | Open-label, cross-over, RCT/37 | Results showed adequate improvement of Shirmer Test and TBUT, but only GenTeal showed reduction of erosions that affected >25% of the corneal surface | 0.027 |
| Tears Again® versus Liposic®,45 | Investigator masked, cross-over, RCT/74 | The tear break-up time in patients treated with Tears Again was increased greater than that of those treated with Liposic at 6 weeks | Both group improvement <0.001 Group difference 0.055 |
Notes: Manufacturers are as follows: Refresh®, Allergan, Irvine, CA, USA; Systane®, Alcon Laboratories, Inc., Fort Worth, TX, USA; Blink®, Abbott Laboratories Inc., Abbott Park, IL, USA; Hylo-Comod®, URSAPHARM, Saarbrücken, Germany; GenTeal®, Novartis Pharmaceuticals, East Hanover, NJ, USA; Soothe®, Bausch & Lomb Incorporated, Bridgewater, NJ, USA; Liposic®, Bausch & Lomb Incorporated; Naturale-Free®, Alcon Laboratories, Inc.; Tears Again®, OcuSoft, Rosenberg, TX, USA.
Abbreviations: BCVA, best-corrected visual acuity; CMC, carboxy methylcellulose; RCT, randomized controlled trial; SS, sample size; ST, study type; TBUT, tear film breakup time.