High-Concentration Phospholipid Sprays Increase Comfort, Tear Film Stability

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While there was no change following use of a low-concentration spray, improvements were significant when the phospholipid concentration was 8 times higher.

Liposomal eye sprays with higher concentrations of phospholipids may improve ocular comfort and team film stability, according to findings published in Eye & Contact Lens.

Researchers conducted a prospective crossover study of 30 participants to evaluate the effect of eye spray phospholipid concentration on symptoms of dry eye disease (DED) and team film stability. In the study, researchers sprayed high- and low-concentration phospholipid eye sprays onto the participants’ closed eyelids after evaluating ocular comfort and noninvasive tear film stability (NIBUT) in each eye. The outcome measures were again recorded 10 minutes and 30 minutes after application. Ocular comfort was measured using the visual analog scale.

The study found that, before application, comfort and NIBUT were not different between sprays (P >.3), but they significantly improved with a high-concentration phospholipid spray at the 10- and 30-minute time points, as compared to the low-concentration spray (comfort: P =.001, NIBUT: P =.016). 

The researchers explain that phospholipids are important components of tear film due to their role in surface monolayer formation as well as their surfactant properties. 

“Ninety-two percent of the meibum consists of neutral lipids, and the remaining 8% of polar lipids,” the study explains. “The polar lipids consist of 70% phospholipids, the most predominant of which is phosphatidylcholine. Deficiency of these components prevents formation of a stable, continuous lipid layer, which, in turn, causes an increased tear evaporation rate.” 

They also note that, to follow up on their study findings, future research could assess the impact of lipid concentration on comfort and tear stability, since the 2 sprays used in the study were identical except for the 8-fold higher concentration of phospholipids in 1 spray.

The study’s primary limitation was its single use of each spray on the participants, although the researchers expect that comfort and NIBUT would increase with more applications. Another limitation was its negligence in using participants with a wider range of dry eye symptoms.

“In case of eyes with aqueous deficiency, phospholipids in conjunction with artificial tears might be beneficial and deserve future investigation,” the study concludes.


Pult H, Khatum FS, Trave-Huarte S, Wolffsohn JS. Effect of eye spray phospholipid concentration on the tear film and ocular comfort. Eye Contact Lens. Published online April 2, 2021. doi:10.1097/ICL.0000000000000788