Abstract: IS thicker goop better?

Sometimes a commonly held assumption is just that - having solid basis in common sense but quite possibly not being borne out by evidence when looked at scientifically. I am reminded by this study of what I learned from Dr. Holly's work so many years ago - that viscosity is not necessarily the answer to better or longer lasting lubrication. It was certainly borne out in my own experience, considering how all the thickest goop never worked as well for me as the drops he formulated.

This study looks at a survey of a large number of Sjogrens patients in the UK. Of all the people using lubricant drops, gels and ointments, the Sjogrens would probably be the ones most likely to be advised by their doctors (or simply figure out on their own) to try the thickest gels and ointments in search of longer lasting relief. However, the data do not conclusively show that they are finding this works for them.

Treatment of dry eye: An analysis of the British Sjögren's Syndrome Association comparing substitute tear viscosity and subjective efficacy.

PURPOSE:
This study aims to address the lack of independent subjective efficacy data on artificial tear substitutes in the treatment of dry eye due to the anecdotal association of 'thicker' products being more effective.

METHODS:
This is an independent study of the subjective use and efficacy of topical treatments used by members of the British Sjögren's Syndrome Association (BSSA) related to product viscosity. 2000 members of the BSSA were sent a questionnaire regarding their physical condition and the use of artificial tear substitutes. Viscosity analysis was performed on the most popular preparations. Statistical comparison is made between subjective efficacies related to substitute tear viscosity.

RESULTS:
1088 patients responded giving information regarding their condition together with the subjective use and efficacy data of artificial tear substitutes. Visco-analysis was performed on the most popular preparations; these had more than 50 patients using them. In terms of subjective benefits related to viscosity for 'frequency' and 'duration' the data suggests a general trend toward viscous preparations being instilled less frequently and lasting longer; however this was not shown to be significantly correlated and some interesting comparisons are reported.

CONCLUSIONS:
The results confirm high levels of ocular lubricant use in the BSSA population. Our data investigates the often-anecdotal evidence that thicker preparations are more effective. However, we did not find this correlation to be statistically significant suggesting further study into factors related to subjective product efficacy. These results lay foundations for the development of future products in the treatment of severe dry eye.

Cont Lens Anterior Eye. 2011 Jun 18. [Epub ahead of print]
Bhojwani R, Cellesi F, Maino A, Jalil A, Haider D, Noble B.
Source
North Lincolnshire and Goole NHS Trust, Woodland Avenue, Goole DN14 6RX, United Kingdom; Manchester Royal Eye Hospital, Oxford Road, Manchester M13 9WL, United Kingdom.