Diquafosol Sodium After Vitrectomy Aids Tear Film Stabilization in Diabetes

Diquafosol sodium ophthalmic solution (DQS) can effectively improve tear film stability following vitrectomy among patients with diabetes mellitus (DM), whether or not they display DM-associated dry eye syndrome (DMDES), according to results of a study published in International Ophthalmology.

The retrospective case-control study was conducted at the Jinan Second People’s Hospital in China between 2020 and 2021. Patients (N=107) who underwent vitrectomy due to diabetic vitreous hemorrhage were divided into experimental and control groups to receive 3% DQS (n=50) or 0.1% sodium hyaluronate control (n=57) 6 times a day for 3 months. 

The DMDES  had 59 participants (mean age, 53.47 years; 20 men, 39 women) had a mean DM duration of 15.73±5.79 years and had a glycated hemoglobin (HbA1C) of 7.01% . The no dry eye disease (DED) group had 48 participants (mean age, 55.5 years; 35 men, 13 women) who had a mean DM duration of 8.83±3.88 years and had a glycated hemoglobin (HbA1C) of 6.10% . 

In the multivariate analysis, risk for DMDES was associated with DM duration (β, 0.756; P =.000), HbA_1C (β, 0.507; P =.018), and gender (β, 0.325; P =.046).

Stratified by DQS and control assignment, the experimental group had significantly lower fasting glucose than the control group (mean, 5.25 vs 6.7 mmol/l; P =0.000), respectively.

At baseline, the DQS and control groups had an average noninvasive breakup time (NIBUT) of 9.82 and 9.87 s, tear meniscus height (TMH) of 176.84 and 180.35 μm, Schirmer I test (SIT) of 7.96 and 8.18 mm/5 min, and ocular surface disease index (OSDI) score of 15.12 and 14.47 points, respectively.

At 3 months post-vitrectomy, the experimental and control groups NIBUT scores had changed to 12.12 and 10.3 s, TMH to 225.70 and 185.12 μm, SIT to 8.78 and 8.77 mm/5 min, and OSDI scores to 10.30 and 14.58 points, respectively.

“The quality of the tear film is an important factor affecting the postoperative comfort of patients,” according to the researchers. “Diquafosol sodium is a uridine triphosphate derivative, which acts on P2Y2 receptors in different parts of ocular conjunctival epithelium, corneal epithelium and meibomian gland, promotes the secretion of ocular surface tears and mucin and increases the thickness of lipid layer in the tear film. The increase in mucin and lipid in the tear film can improve the stability of the tear film.”

This study may have been limited by only including patients with DM, it remains unclear what the effect of DQS may have on other conditions necessitating vitrectomy.