Dry eyedisease compounds…
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developed to occlude the lacrimal puncta and they can be absorbable and non-‐
absorbable (18). These devices keep tears longer on the ocular surface relieving
the patient’s from the undesirable symptoms. Other type of treatment is the
moisture chamber spectacles. It has been reported that increased periocular
humidity can cause the tear film lipid layer to thicken and that spectaclewearers
with dry eye have a longer inter-‐blink interval than the non-‐spectacle wearers
(19). Current treatments aremainly focused on addressing inflammation and tear
restoration (20). Dry eye disease is the outcome of many factors resulting in
inflammation of cornea and conjunctiva. The dysfunction of the tear secretory
glands leads to changes in tear composition such as hyper-‐osmolarity which
stimulates the production of inflammatory mediators on the ocular surface. This
inflammation can be initiated either by chronic irritative stress like wearing
contact lens wearing or from a systemic inflammatory autoimmune disease like
rheumatoid arthritis (21, 22). Anti-‐inflammatory drugs are widely used for the
treatment of the inflammation produced by diseases. Topical corticosteroids can
relieve moderate or severe dry eye symptoms and signs rapidly and effectively
(23). Steroids on theother handmay cause severe side effects after prolongeduse.
The undesired effects vary frombacterial or fungal infection, elevated intraocular
pressure and cataract formation. Additionally, steroids suppress locally the
immune response inpatientswithalready compromisedocular surface. Therefore,
steroidsare typicallyusedonly fora limitedperiodof time indryeyepatients (20).
Due to the above-‐mentioned reasons, non-‐steroidal anti-‐inflammatory drugs
(NSAID) credited as causing less severe side effects are recently evaluated as a
potential dry eye treatment. The NSAIDs could decrease inflammation and eye
discomfort due to their analgesic effect, but they might induce DED decreasing
sensitivity. In 2002 U.S. Food and Drug Administration (FDA) approved the drug
RESTASIS
®of the company Allergan as the first prescriptionmedicine capable to
increase tear production (24). Topical
RESTASIS
® is an ophthalmic emulsion
containing cyclosporine 0.05%. Other types of drug used are the antibiotics like
azithromycin, and tetracycline. Furthermore, some research groups are studying
the use of serumtears and the intense pulse light as potential treatments (20). On
the following pages, we present some future treatments currently passing clinical
trials.
AL-‐2178/RIMEXOLONE
AL-‐2178/Rimexolone 1% (Figure 2) is a glucocorticoid steroid developed
by Alcon, as a treatment for dry eye disease. Rimexolone inhibits T-‐cell
